Provider Demographics
NPI:1043383474
Name:WHITE, KATHERINE ELIZABETH (MFT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:WHITE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:3873 PIEDMONT AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5370
Mailing Address - Country:US
Mailing Address - Phone:408-396-5237
Mailing Address - Fax:
Practice Address - Street 1:3873 PIEDMONT AVE STE 5
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5370
Practice Address - Country:US
Practice Address - Phone:408-396-5237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46564101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health