MEDICARE: KAYLA IMHOFF

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	101YM0800X	Mental Health Counselor	LMFT161444	CA

General Provider Information

NPI Number	:	1841867926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA IMHOFF

Provider Business Mailing Address
First Line	:	PO BOX 373
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91031-0373
Country	:	US
Telephone Number	:	323-435-6920
Fax Number	:

Provider Business Practice Location Address
First Line	:	849 N LAKE AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91104-4561
Country	:	US
Telephone Number	:	323-435-6920
Fax Number	:

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

Provider Enumeration Date	:	06/08/2021
Last Update Date	:	04/06/2026

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Directions to “ KAYLA IMHOFF ” Practice Location

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