Provider Demographics
NPI:1881855070
Name:KUGEL, CARL FREDERICK (MA, MFT)
Entity type:Individual
Prefix:MR
First Name:CARL
Middle Name:FREDERICK
Last Name:KUGEL
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 OCEAN AVE
Mailing Address - Street 2:#230
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2108
Mailing Address - Country:US
Mailing Address - Phone:310-459-1782
Mailing Address - Fax:
Practice Address - Street 1:1551 OCEAN AVE
Practice Address - Street 2:#230
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2108
Practice Address - Country:US
Practice Address - Phone:310-459-1782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29603106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist