Individual provider Active NPI

Kristen Love Quevedo, M.A., MFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1013148592
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC #51304 Issued in CA
Practice address
11601 Wilshire Blvd Ste 2060
Los Angeles, CA 90025-0509
Phone
(310) 494-0355
NPI assigned
Aug 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC #51304 CA Primary

Addresses

Primary practice location

11601 Wilshire Blvd Ste 2060
Los Angeles, CA 90025-0509

Mailing address

11601 Wilshire Blvd Ste 2060
Los Angeles, CA 90025-0509
Phone (310) 494-0355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC #51304CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1013148592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11601 WILSHIRE BLVD STE 2060",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900250509",
            "telephone_number": "310-494-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 WILSHIRE BLVD STE 2060",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900250509",
            "telephone_number": "310-494-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEVEDO",
        "first_name": "KRISTEN",
        "middle_name": "LOVE",
        "credential": "M.A., MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-02",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC #51304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.