Krystle M Pumarejo, LEP, MS, PPS

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LEP3413 Issued in CA

Practice address

4470 W Sunset Blvd Ste
Los Angeles, CA 90027-6309

Phone

(323) 798-7413

Fax

(833) 419-0181

NPI assigned

Jan 4, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Krystle M Orozco Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1033822127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 W PALO ALTO AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937222001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4470 W SUNSET BLVD STE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276309",
            "telephone_number": "323-798-7413",
            "fax_number": "833-419-0181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6240 W Palo Alto Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937222001",
            "country_code": "US",
            "telephone_number": "559-325-4732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUMAREJO",
        "first_name": "KRYSTLE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LEP, MS, PPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "LEP3413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTLE",
            "last_name": "OROZCO",
            "middle_name": "M",
            "prefix": "MRS.",
            "credential": "LEP, MS, PPS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brighid June Pulskamp Lewis
• Nora Roisin Pulskamp
• Tariq Pulskamp, PHARMD
• Johannes Benjamin Pulst-Korenberg, MD
• Tessy Tatiana Pumaccahua, PH.D., LP
• Stacey Pun, MD
• Jaya Punati, MD
• Diksha Punia
• Stefani Punneli
• Celeste Punsal, FNP-C

• Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.