| K Derifield Lmft Inc | |
|
218 W Main St Ste 104 Tustin CA 92780-7709 | |
| (714) 267-7651 | |
| Not Available |
| Full Name | K Derifield Lmft Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 218 W Main St Ste 104, Tustin, California |
| Authorized Official Name and Position | Kellie Derifield (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7142677651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| K Derifield Lmft Inc 2330 E Wilson Ave Orange CA 92867-6164 Ph: (714) 267-7651 | K Derifield Lmft Inc 218 W Main St Ste 104 Tustin CA 92780-7709 Ph: (714) 267-7651 |
| NPI Number | 1639861016 |
|---|---|
| Provider Enumeration Date | 05/23/2023 |
| Last Update Date | 05/23/2023 |
| Certification Date | 05/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639861016 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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