Provider Demographics
NPI:1245014588
Name:SAULS, KRISTALENA (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTALENA
Middle Name:
Last Name:SAULS
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 1:216 GRAND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6842
Mailing Address - Country:US
Mailing Address - Phone:909-557-3752
Mailing Address - Fax:
Practice Address - Street 1:216 GRAND VIEW DR
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-6842
Practice Address - Country:US
Practice Address - Phone:909-557-3752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1167631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical