| Doctor Name: | KRYSTA PILAR MEANY |
| NPI Number: | 1629483540 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | 27556 |
| Business Practice Address: | 20320 Sorrento Ln Unit 102 Porter Ranch, CA - 913264498 |
| Business Phone Number: | 8583576340 |
| Business Fax Number: | |
| Mailing Address: | 830 Scenic Terrace Pl, CHULA VISTA |
| State: | CA |
| Postal Code: | 919142621 |
| Phone Number: | 6197220014 |
| Fax Number: | 9493906519 |
| NPI Enumeration Date: | 06/30/2014 |
| NPI Last Update Date: | 09/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 27556 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |