Provider Demographics
NPI:1558807792
Name:KILBERG, REGINA (LMFT)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:KILBERG
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15300 VENTURA BLVD # 508A
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3103
Mailing Address - Country:US
Mailing Address - Phone:818-943-1778
Mailing Address - Fax:
Practice Address - Street 1:19634 VENTURA BLVD
Practice Address - Street 2:#212
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2966
Practice Address - Country:US
Practice Address - Phone:818-758-9450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-11
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105669106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist