Provider Demographics
NPI:1245021534
Name:KEVIN KUNKEL AND ASSOCIATES, THERAPY FOR ADULTS AND CHILDREN
Entity type:Organization
Organization Name:KEVIN KUNKEL AND ASSOCIATES, THERAPY FOR ADULTS AND CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNKEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-691-9079
Mailing Address - Street 1:122 LINCOLN BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-2859
Mailing Address - Country:US
Mailing Address - Phone:310-691-9079
Mailing Address - Fax:
Practice Address - Street 1:122 LINCOLN BLVD STE 203
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-2859
Practice Address - Country:US
Practice Address - Phone:310-691-9079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty