MEDICARE: BEN KREADER LMFT

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
1	106H00000X	Marriage & Family Therapist	148233	CA

General Provider Information

NPI Number	:	1619558012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEN KREADER LMFT

Provider Business Mailing Address
First Line	:	1825 N VERMONT AVE UNIT 27602
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6450
Country	:	US
Telephone Number	:	323-379-2350
Fax Number	:

Provider Business Practice Location Address
First Line	:	4027 HOLLY KNOLL DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-3219
Country	:	US
Telephone Number	:	323-379-2350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2021
Last Update Date	:	08/03/2024

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Directions to “ BEN KREADER LMFT” Practice Location

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