Basic Information
Provider Information
NPI: 1194229377
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KRIMPLE
FirstName: JOSEPH
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: LMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6200 WILSHIRE BLVD STE 1010
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900485811
CountryCode: US
TelephoneNumber: 4242842440
FaxNumber:  
Practice Location
Address1: 6200 WILSHIRE BLVD STE 1010
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900485811
CountryCode: US
TelephoneNumber: 4242842440
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/21/2018
LastUpdateDate: 03/21/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XLMFT104654CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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