Provider Demographics
NPI:1437276680
Name:HART, KRISTINA BAKER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:BAKER
Last Name:HART
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KRISTINA
Other - Middle Name:HEDY
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ASW
Mailing Address - Street 1:166 KERN ST
Mailing Address - Street 2:UNIT 13
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-2054
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:433 SALINAS ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2717
Practice Address - Country:US
Practice Address - Phone:831-757-7915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2018-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
CALCSW786721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical