Provider Demographics
NPI:1912023805
Name:KUNTZE, ERIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:KUNTZE
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 1:9696 CULVER BLVD STE 303
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2759
Mailing Address - Country:US
Mailing Address - Phone:424-259-3832
Mailing Address - Fax:
Practice Address - Street 1:9696 CULVER BLVD STE 303
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2759
Practice Address - Country:US
Practice Address - Phone:424-259-3832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23832103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
11285OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER