Provider Demographics
NPI:1497311849
Name:KYNCL, LUZ (LCSW)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:
Last Name:KYNCL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 S RIMPAU BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-4830
Mailing Address - Country:US
Mailing Address - Phone:310-488-5236
Mailing Address - Fax:
Practice Address - Street 1:292 S LA CIENEGA BLVD STE 320
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3318
Practice Address - Country:US
Practice Address - Phone:310-488-5236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA872891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical