Provider Demographics
NPI:1922499466
Name:KARDIBAN, BRITNEE LEANNE (MS)
Entity Type:Individual
Prefix:MRS
First Name:BRITNEE
Middle Name:LEANNE
Last Name:KARDIBAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:BRITNEE
Other - Middle Name:LEANNE
Other - Last Name:VALLIERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:25202 CRENSHAW BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25202 CRENSHAW BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6135
Practice Address - Country:US
Practice Address - Phone:310-701-3992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77083106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist