MEDICARE: JEFFREY JOSEPH KAISER I MA, AMFT

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	151271	CA

General Provider Information

NPI Number	:	1659190056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY JOSEPH KAISER I MA, AMFT

Provider Business Mailing Address
First Line	:	6340 GREEN VALLEY CIR APT 110
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-7093
Country	:	US
Telephone Number	:	213-400-0657
Fax Number	:

Provider Business Practice Location Address
First Line	:	6340 GREEN VALLEY CIR APT 110
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-7093
Country	:	US
Telephone Number	:	213-400-0657
Fax Number	:

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

Provider Enumeration Date	:	10/03/2024
Last Update Date	:	04/02/2025

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