1447696901 NPI number — MRS. RAQUEL TAMAR KISLINGER M.A.

Table of content: MRS. RAQUEL TAMAR KISLINGER M.A. (NPI 1447696901)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447696901 NPI number — MRS. RAQUEL TAMAR KISLINGER M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KISLINGER
Provider First Name:
RAQUEL
Provider Middle Name:
TAMAR
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447696901
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
95 NORTH MARENGO AVENUE, SUITE 100
Provider Second Line Business Mailing Address:
INSTITUTE FOR GIRLS' DEVELOPMENT
Provider Business Mailing Address City Name:
PASADENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-585-8075
Provider Business Mailing Address Fax Number:
626-585-0440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
95 NORTH MARENGO AVENUE, SUITE 100
Provider Second Line Business Practice Location Address:
INSTITUTE FOR GIRLS' DEVELOPMENT
Provider Business Practice Location Address City Name:
PASADENA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-585-8075
Provider Business Practice Location Address Fax Number:
626-585-0440
Provider Enumeration Date:
05/10/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  LMFT83601 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106H00000X , with the licence number: MFTI 64036 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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