Provider Demographics
NPI:1649728288
Name:CASTLE, KRISTEN (LMFT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:CASTLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KRYSS
Other - Middle Name:
Other - Last Name:CASTLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:703 PIER AVE
Mailing Address - Street 2:SUITE B#215
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-3949
Mailing Address - Country:US
Mailing Address - Phone:424-265-8001
Mailing Address - Fax:310-356-3562
Practice Address - Street 1:336 TEJON PL
Practice Address - Street 2:
Practice Address - City:PALOS VERDES ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-1204
Practice Address - Country:US
Practice Address - Phone:424-265-8001
Practice Address - Fax:310-356-3562
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95114106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist