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Search › California › Prevention Professional

Kristofer Pettway

NPI 1427783315 · on the registry since 2022 · sole proprietor

Practice

Address
411 S Normade Ave Apt 732
Los Angeles, CA 90020
Phone
(516) 919-0061
Clinicians at this address
2

Registry record

Primary taxonomy
Prevention Professional
405300000X
Licence states on file
NY
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-07-23
Status
Not present in the most recent federal file

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California