Provider Demographics
NPI:1659980514
Name:PARKER, KRISTA (MA, AMFT, APCC)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:MA, AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7727 LANKERSHIM BLVD APT 111
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-6521
Mailing Address - Country:US
Mailing Address - Phone:818-220-3799
Mailing Address - Fax:
Practice Address - Street 1:22231 MULHOLLAND HWY STE 200
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-5173
Practice Address - Country:US
Practice Address - Phone:818-217-0463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119863101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health