Provider Demographics
NPI:1548400120
Name:LOGER, KRISTY KAY (N/A)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:KAY
Last Name:LOGER
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13111 HUBBARD ST
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-3305
Mailing Address - Country:US
Mailing Address - Phone:818-364-1310
Mailing Address - Fax:
Practice Address - Street 1:8604 LANKERSHIM BLVD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-3140
Practice Address - Country:US
Practice Address - Phone:818-768-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)