Provider Demographics
NPI:1689830341
Name:DELGADO, KRYSTAL LEE (INTERN MFT)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:LEE
Last Name:DELGADO
Suffix:
Gender:F
Credentials:INTERN MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1282 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-5832
Mailing Address - Country:US
Mailing Address - Phone:213-201-5380
Mailing Address - Fax:213-355-1249
Practice Address - Street 1:1282 W 2ND ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-5832
Practice Address - Country:US
Practice Address - Phone:213-201-5380
Practice Address - Fax:213-355-1249
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor