Provider Demographics
NPI:1073101044
Name:CULBERTSON, KARINA MARIE (AMFT)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:MARIE
Last Name:CULBERTSON
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9035 TERHUNE AVE
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2020
Mailing Address - Country:US
Mailing Address - Phone:818-425-2276
Mailing Address - Fax:
Practice Address - Street 1:4421 W RIVERSIDE DR STE 102
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4051
Practice Address - Country:US
Practice Address - Phone:818-748-8818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122259106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist