Provider Demographics
NPI:1922724764
Name:KRONFELD, KEVIN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:KRONFELD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 GATES AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-2025
Mailing Address - Country:US
Mailing Address - Phone:909-261-9970
Mailing Address - Fax:
Practice Address - Street 1:2225 GATES AVE UNIT B
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-2025
Practice Address - Country:US
Practice Address - Phone:909-261-9970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41184106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty