Provider Demographics
NPI:1598106197
Name:STRAND, KIRSTEN TENAY (BHS II)
Entity type:Individual
Prefix:MS
First Name:KIRSTEN
Middle Name:TENAY
Last Name:STRAND
Suffix:
Gender:F
Credentials:BHS II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 RICHLAND AVE STE C-2
Mailing Address - Street 2:
Mailing Address - City:CERES
Mailing Address - State:CA
Mailing Address - Zip Code:95307-4562
Mailing Address - Country:US
Mailing Address - Phone:209-525-5079
Mailing Address - Fax:209-541-2549
Practice Address - Street 1:1904 RICHLAND AVE STE C-2
Practice Address - Street 2:
Practice Address - City:CERES
Practice Address - State:CA
Practice Address - Zip Code:95307-4562
Practice Address - Country:US
Practice Address - Phone:209-525-5079
Practice Address - Fax:209-541-2549
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAS1207141642101YA0400X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)