Provider Demographics
NPI:1912697251
Name:SPRINGSTEEN, KRISTEN DANIELLE (LMFT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:DANIELLE
Last Name:SPRINGSTEEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27412 ENTERPRISE CIR W
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4803
Mailing Address - Country:US
Mailing Address - Phone:951-972-6262
Mailing Address - Fax:
Practice Address - Street 1:27412 ENTERPRISE CIR W
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4803
Practice Address - Country:US
Practice Address - Phone:951-972-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT139243101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health