Provider Demographics
NPI:1790801025
Name:ELGIN, KRISTINE A (LMFT)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:A
Last Name:ELGIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4515 PALMERO DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-4236
Mailing Address - Country:US
Mailing Address - Phone:323-378-7781
Mailing Address - Fax:
Practice Address - Street 1:4515 PALMERO DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-4236
Practice Address - Country:US
Practice Address - Phone:323-378-7781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health