Provider Demographics
NPI:1164753380
Name:SCALFARO, KRISTIN LEE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:LEE
Last Name:SCALFARO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 MAPLE CT
Mailing Address - Street 2:SUITE 250
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3516
Mailing Address - Country:US
Mailing Address - Phone:805-216-2047
Mailing Address - Fax:
Practice Address - Street 1:260 MAPLE CT
Practice Address - Street 2:SUITE 250
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3516
Practice Address - Country:US
Practice Address - Phone:805-216-2047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47967106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist