Provider Demographics
NPI:1205129079
Name:KERRONE, DUSTIN (LMFT)
Entity type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:
Last Name:KERRONE
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 1:7080 HOLLYWOOD BLVD STE 801
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-6935
Mailing Address - Country:US
Mailing Address - Phone:323-309-5350
Mailing Address - Fax:
Practice Address - Street 1:7080 HOLLYWOOD BLVD STE 801
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-6935
Practice Address - Country:US
Practice Address - Phone:323-309-5350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50038106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist