Provider Demographics
NPI:1578139952
Name:CYPRIEN, KRISTIN EILEEN (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:EILEEN
Last Name:CYPRIEN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1123
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92856-0123
Mailing Address - Country:US
Mailing Address - Phone:951-712-2009
Mailing Address - Fax:
Practice Address - Street 1:112 E CHAPMAN AVE STE A5
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1454
Practice Address - Country:US
Practice Address - Phone:951-712-2009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA115206106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist