Provider Demographics
NPI:1033407622
Name:KEMPNER, ETANA G (LCSW)
Entity Type:Individual
Prefix:
First Name:ETANA
Middle Name:G
Last Name:KEMPNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32392 S. COAST HWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651
Mailing Address - Country:US
Mailing Address - Phone:949-636-8460
Mailing Address - Fax:949-499-2276
Practice Address - Street 1:32392 COAST HWY
Practice Address - Street 2:SUITE 250
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-6776
Practice Address - Country:US
Practice Address - Phone:949-499-2265
Practice Address - Fax:949-499-2276
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA271771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical