Provider Demographics
NPI:1598044398
Name:PIKIEWICZ, KRISTI A (PHD)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:A
Last Name:PIKIEWICZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2493 N FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1216
Mailing Address - Country:US
Mailing Address - Phone:805-559-2024
Mailing Address - Fax:
Practice Address - Street 1:2493 N FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1216
Practice Address - Country:US
Practice Address - Phone:805-559-2024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CONLC.0103442103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program