Provider Demographics
NPI:1275698011
Name:KENYON, KRISTINA (LMFT)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:KENYON
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 1:650 5TH ST STE 309
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1542
Mailing Address - Country:US
Mailing Address - Phone:415-995-1700
Mailing Address - Fax:
Practice Address - Street 1:650 5TH ST STE 309
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1542
Practice Address - Country:US
Practice Address - Phone:415-995-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51852106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist