Provider Demographics
NPI:1518296953
Name:KITAEN-MORSE, BEVERLY (BEVERLY KITAEN-MORSE)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:
Last Name:KITAEN-MORSE
Suffix:
Gender:F
Credentials:BEVERLY KITAEN-MORSE
Other - Prefix:DR
Other - First Name:BEVERLY
Other - Middle Name:
Other - Last Name:KITAEN-MORSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BEVERLY KITAEN-MORSE
Mailing Address - Street 1:1551 OCEAN AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2108
Mailing Address - Country:US
Mailing Address - Phone:310-458-1662
Mailing Address - Fax:
Practice Address - Street 1:1551 OCEAN AVENUE
Practice Address - Street 2:SUITE 230
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2108
Practice Address - Country:US
Practice Address - Phone:310-458-1662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC19646106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist