Provider Demographics
NPI:1356412795
Name:ROSS, KRISTI ANN (LCSW,CADC)
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:ANN
Last Name:ROSS
Suffix:
Gender:F
Credentials:LCSW,CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 749
Mailing Address - Street 2:
Mailing Address - City:MORRO BAY
Mailing Address - State:CA
Mailing Address - Zip Code:93443-2417
Mailing Address - Country:US
Mailing Address - Phone:805-466-3856
Mailing Address - Fax:805-776-5020
Practice Address - Street 1:895 NAPA AVE.
Practice Address - Street 2:STE B-2
Practice Address - City:MORRO BAY
Practice Address - State:CA
Practice Address - Zip Code:93442-2417
Practice Address - Country:US
Practice Address - Phone:805-466-3856
Practice Address - Fax:805-776-5020
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS212321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical