Provider Demographics
NPI:1184740631
Name:DRIVER, KRISTA BETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:BETH
Last Name:DRIVER
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 1:1845 W ORANGEWOOD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2053
Mailing Address - Country:US
Mailing Address - Phone:714-547-6494
Mailing Address - Fax:714-547-9990
Practice Address - Street 1:1845 W ORANGEWOOD AVE STE 300
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2053
Practice Address - Country:US
Practice Address - Phone:714-588-1416
Practice Address - Fax:714-628-9671
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACO559105101YA0400X
CA40937106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)