Provider Demographics
NPI:1477744860
Name:KREMS, ILENE (MFT)
Entity Type:Individual
Prefix:DR
First Name:ILENE
Middle Name:
Last Name:KREMS
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 1:7212 RAINTREE CIR
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4455
Mailing Address - Country:US
Mailing Address - Phone:310-287-1466
Mailing Address - Fax:310-287-4721
Practice Address - Street 1:7212 RAINTREE CIR
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4455
Practice Address - Country:US
Practice Address - Phone:310-287-1466
Practice Address - Fax:310-287-4721
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34516106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist