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Provider Information for 1134433394


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Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

KILA THERESE DAMES


Sex: Female

NPI: 1134433394
Last Updated: 2022-03-01
Certification Date: 2022-03-01

Details

NameValue
NPI1134433394
Enumeration Date2010-07-29
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 2640 INDUSTRY WAY
LYNWOOD, CA 90262-4284
United States

Phone: 310-221-6336 | Fax:
 
Primary Practice Address 2640 INDUSTRY WAY
LYNWOOD, CA 90262-4284
United States

Phone: 310-221-6336 | Fax:
 
Secondary Practice Address(es)

901 N PACIFIC COAST HWY
SUITE 200A
REDONDO BEACH, CA 90277-2162
United States

Phone: 310-906-6752 | Fax:310-316-4209
 

1501 HUGHES WAY STE 150
LONG BEACH, CA 90810-1878
United States

Phone: 310-221-6336 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 106H00000X - Marriage & Family Therapist CAAMFT99873
No 106H00000X - Marriage & Family Therapist
Yes 106H00000X - Marriage & Family Therapist CA128304