Provider Demographics
NPI:1659190056
Name:KAISER, JEFFREY JOSEPH I (MA, AMFT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:JOSEPH
Last Name:KAISER
Suffix:I
Gender:
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:KAISER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, AMFT
Mailing Address - Street 1:6340 GREEN VALLEY CIR APT 110
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-7093
Mailing Address - Country:US
Mailing Address - Phone:213-400-0657
Mailing Address - Fax:
Practice Address - Street 1:6340 GREEN VALLEY CIR APT 110
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-7093
Practice Address - Country:US
Practice Address - Phone:213-400-0657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA151271106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist