Provider Demographics
NPI:1235853524
Name:RITTENBERRY-KRAEMER, JOLIE ROSALILY
Entity Type:Individual
Prefix:
First Name:JOLIE ROSALILY
Middle Name:
Last Name:RITTENBERRY-KRAEMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 YORK BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-3720
Mailing Address - Country:US
Mailing Address - Phone:213-924-3935
Mailing Address - Fax:
Practice Address - Street 1:4011 YORK BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-3720
Practice Address - Country:US
Practice Address - Phone:213-924-3935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist