Provider Demographics
NPI:1134203672
Name:KRESS, AMY CAROLYN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:CAROLYN
Last Name:KRESS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15590 OLDEN ST
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342
Mailing Address - Country:US
Mailing Address - Phone:818-362-9383
Mailing Address - Fax:818-364-5808
Practice Address - Street 1:11303 W. WASHINGTON BLVD
Practice Address - Street 2:STE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-6003
Practice Address - Country:US
Practice Address - Phone:310-482-6650
Practice Address - Fax:310-313-0973
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS140011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical