Provider Demographics
NPI:1326566019
Name:CREED, KRISTI A (ACSW, PSB)
Entity type:Individual
Prefix:MS
First Name:KRISTI
Middle Name:A
Last Name:CREED
Suffix:
Gender:
Credentials:ACSW, PSB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:CA
Mailing Address - Zip Code:93644-0005
Mailing Address - Country:US
Mailing Address - Phone:424-284-9249
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 5
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644-0005
Practice Address - Country:US
Practice Address - Phone:424-284-9249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-02
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1073311041C0700X
CAPSB94025941103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1477887834Medicaid