Provider Demographics
NPI:1104408764
Name:CRIGLER, KYNDLE BETH (MSW)
Entity type:Individual
Prefix:
First Name:KYNDLE
Middle Name:BETH
Last Name:CRIGLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KYNDLE
Other - Middle Name:BETH
Other - Last Name:BUFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:21935 VAN BUREN ST STE A-1
Mailing Address - Street 2:
Mailing Address - City:GRAND TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:92313-5652
Mailing Address - Country:US
Mailing Address - Phone:909-906-1023
Mailing Address - Fax:
Practice Address - Street 1:21935 VAN BUREN ST STE A-1
Practice Address - Street 2:
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-5652
Practice Address - Country:US
Practice Address - Phone:909-906-1023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical