Provider Demographics
NPI:1861259319
Name:TOWNE, KIRSTEN MARIE (ASW)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:MARIE
Last Name:TOWNE
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 1:277 SOUTH ST STE W
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-5058
Mailing Address - Country:US
Mailing Address - Phone:805-503-5783
Mailing Address - Fax:805-782-8711
Practice Address - Street 1:277 SOUTH ST STE W
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-5058
Practice Address - Country:US
Practice Address - Phone:805-503-5783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119462104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker