Provider Demographics
NPI:1447584974
Name:BARRETTE, KRISTY ANN (MS)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:ANN
Last Name:BARRETTE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:ANN
Other - Last Name:PACKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:830 TURQUOISE DR
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-4416
Mailing Address - Country:US
Mailing Address - Phone:805-242-5711
Mailing Address - Fax:
Practice Address - Street 1:830 TURQUOISE DR
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-4416
Practice Address - Country:US
Practice Address - Phone:805-242-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85749106H00000X
CA65362101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist