Provider Demographics
NPI:1699434415
Name:CULPEPPER, KRISTINA (ASW)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:CULPEPPER
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2949 PORTAGE BAY W APT 103
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-2829
Mailing Address - Country:US
Mailing Address - Phone:405-605-9595
Mailing Address - Fax:
Practice Address - Street 1:414 4TH ST STE D
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-4000
Practice Address - Country:US
Practice Address - Phone:530-406-7993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical