Provider Demographics
NPI:1669904587
Name:KALSTEIN, KATELYN STORY (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:STORY
Last Name:KALSTEIN
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:STORY
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11650 RIVERSIDE DR.
Mailing Address - Street 2:PH-2A
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91602
Mailing Address - Country:US
Mailing Address - Phone:818-747-2331
Mailing Address - Fax:
Practice Address - Street 1:11650 RIVERSIDE DR.
Practice Address - Street 2:PH-2A
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91602
Practice Address - Country:US
Practice Address - Phone:818-747-2331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60693317175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath