Provider Demographics
NPI:1548560329
Name:KRIMMER, RIVER (LMFT)
Entity Type:Individual
Prefix:
First Name:RIVER
Middle Name:
Last Name:KRIMMER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:JORDEN
Other - Middle Name:
Other - Last Name:KRIMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 362
Mailing Address - Street 2:
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-0362
Mailing Address - Country:US
Mailing Address - Phone:831-247-3984
Mailing Address - Fax:
Practice Address - Street 1:425 CAPITOLA AVE STE 1
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-3363
Practice Address - Country:US
Practice Address - Phone:831-247-3984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108756106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist