Provider Demographics
NPI:1639214539
Name:KLEIN, TURTLE K A
Entity Type:Individual
Prefix:MS
First Name:TURTLE
Middle Name:K A
Last Name:KLEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 N L ST
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-5902
Mailing Address - Country:US
Mailing Address - Phone:805-735-1802
Mailing Address - Fax:
Practice Address - Street 1:226 N L ST
Practice Address - Street 2:218 NORTH I STREET
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-5902
Practice Address - Country:US
Practice Address - Phone:805-735-1802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARI-K0701301324101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)