Kristine Veronica Izedi, MS

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT101512 Issued in CA

Practice address

4740 N Grand Ave
Covina, CA 91724-2005

Phone

(626) 859-2089

Fax

(626) 859-6537

NPI assigned

Oct 30, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristine V Mac Donald 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": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537142400000",
    "number": "1649782707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N GRAND AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917242005",
            "telephone_number": "626-859-2089",
            "fax_number": "626-859-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 N GRAND AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917242005",
            "telephone_number": "626-859-2089",
            "fax_number": "626-859-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZEDI",
        "first_name": "KRISTINE",
        "middle_name": "VERONICA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF101512",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT101512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "MAC DONALD",
            "middle_name": "V",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ivan L Breed MD Inc
• Camille Iverson
• Leilani Iwankiw
• Jose Antonio Ixta-Matute
• Adelina Ixta
• Mark Izquierdo-Gallegos
• J&K Orthopedics Inc
• Teneil Patricia Jacks
• Curtis Jackson
• Erika Dawn Jackson

• Marriage & Family Therapist in Covina, CA
• Providers in Covina, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; 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.