Provider Demographics
NPI:1780866285
Name:KLEPPE, KRISTIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:KLEPPE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 IRVINE CENTER DR
Mailing Address - Street 2:SUITE 800
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618
Mailing Address - Country:US
Mailing Address - Phone:949-528-6300
Mailing Address - Fax:855-779-3627
Practice Address - Street 1:7700 IRVINE CENTER DR
Practice Address - Street 2:SUITE 800
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2923
Practice Address - Country:US
Practice Address - Phone:949-528-6300
Practice Address - Fax:855-779-3627
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24845103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6594140Medicaid
CAGK121AMedicare PIN