Provider Demographics
NPI:1902947914
Name:SPANGLER, KRISTA (LMFT)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KRIS
Other - Middle Name:
Other - Last Name:SPANGLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:536 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-4261
Mailing Address - Country:US
Mailing Address - Phone:707-829-8293
Mailing Address - Fax:707-861-3094
Practice Address - Street 1:536 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4261
Practice Address - Country:US
Practice Address - Phone:707-829-8293
Practice Address - Fax:707-861-3094
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40841106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist