Provider Demographics
NPI:1467898270
Name:IBRAHIMI, KRISTINE (MFT)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:IBRAHIMI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26102 CALLE CRESTA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-5252
Mailing Address - Country:US
Mailing Address - Phone:949-293-8166
Mailing Address - Fax:
Practice Address - Street 1:18381 GOLDENWEST ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1107
Practice Address - Country:US
Practice Address - Phone:714-842-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist