1215785407 NPI number — ALISA CHELSEA KYLE-MARTINSEN LMFT

Table of content: ALISA CHELSEA KYLE-MARTINSEN LMFT (NPI 1215785407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215785407 NPI number — ALISA CHELSEA KYLE-MARTINSEN LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KYLE-MARTINSEN
Provider First Name:
ALISA
Provider Middle Name:
CHELSEA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT
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:
1215785407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1940 20TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94116-1201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FAGERSTRANDVEIEN 30
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STABEKK
Provider Business Practice Location Address State Name:
1368
Provider Business Practice Location Address Postal Code:
VIKEN
Provider Business Practice Location Address Country Code:
NO
Provider Business Practice Location Address Telephone Number:
415-509-4037
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/11/2024

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:  143212 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com