Basic Information
Provider Information
NPI: 1144340464
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KROPF
FirstName: JEFFREY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2244 FORBES AVE
Address2:  
City: CLAREMONT
State: CA
PostalCode: 917111713
CountryCode: US
TelephoneNumber: 9093999129
FaxNumber:  
Practice Location
Address1: 1350 3RD ST
Address2:  
City: LA VERNE
State: CA
PostalCode: 917505201
CountryCode: US
TelephoneNumber: 9095965921
FaxNumber: 9095963954
Other Information
ProviderEnumerationDate: 03/30/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPSY12969CAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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