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NPI Code Detail

MEDICARE: MS. KRISTINE LEE ANN CROTHERS

MEDICARE: MS. KRISTINE LEE ANN CROTHERS
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) Counselor
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1992963979
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTINE LEE ANN CROTHERS
Provider Business Mailing Address
First Line : 16600 SHERMAN WAY
Second Line :
City : VAN NUYS
State : CA
Zip : 91406-3875
Country : US
Telephone Number : 818-235-1414
Fax Number :
Provider Business Practice Location Address
First Line : 16600 SHERMAN WAY
Second Line :
City : VAN NUYS
State : CA
Zip : 91406-3875
Country : US
Telephone Number : 818-235-1414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2008
Last Update Date : 06/18/2025

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