Provider Demographics
NPI:1346540614
Name:FRECK, KRISTINE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:ANN
Last Name:FRECK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 GWYNE AVE
Mailing Address - Street 2:COUNSEL FOR THE SOUL
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2418
Mailing Address - Country:US
Mailing Address - Phone:805-679-3003
Mailing Address - Fax:
Practice Address - Street 1:839 GWYNE AVE
Practice Address - Street 2:COUNSEL FOR THE SOUL
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2418
Practice Address - Country:US
Practice Address - Phone:805-679-3003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 27171106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist