Provider Demographics
NPI:1881420255
Name:FRANK, KRISTINE (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:FRANK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80415 SEGOVIA VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-0907
Mailing Address - Country:US
Mailing Address - Phone:914-330-9531
Mailing Address - Fax:
Practice Address - Street 1:44651 VILLAGE CT STE 129
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3823
Practice Address - Country:US
Practice Address - Phone:760-501-8044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1255771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical