Provider Demographics
NPI:1124150800
Name:CRESPO, KIMBERLY NOELLE (MS-MFTI)
Entity type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:NOELLE
Last Name:CRESPO
Suffix:
Gender:F
Credentials:MS-MFTI
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:NOELLE
Other - Last Name:FLECK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:7360 WOODVALE CT
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1443
Mailing Address - Country:US
Mailing Address - Phone:818-613-6744
Mailing Address - Fax:
Practice Address - Street 1:7360 WOODVALE CT
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1443
Practice Address - Country:US
Practice Address - Phone:818-613-6744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53824106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA53824OtherBBS