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NPI Code Detail

MEDICARE: KRISTINA BUTNER LCSW

MEDICARE: KRISTINA BUTNER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor770100966CA

General Provider Information

NPI Number : 1407030778
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA BUTNER LCSW
Provider Business Mailing Address
First Line : 1900 E 4TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-3962
Country : US
Telephone Number : 714-796-4800
Fax Number : 408-281-7149
Provider Business Practice Location Address
First Line : 1900 E 4TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-3962
Country : US
Telephone Number : 714-796-4800
Fax Number : 408-281-7149
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2007
Last Update Date : 10/06/2021

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Directions to “ KRISTINA BUTNER LCSW” Practice Location

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