Provider Demographics
NPI:1043448616
Name:JAMES, KATHRYN AIMEE REBECCA (MFT 46494)
Entity Type:Individual
Prefix:MISS
First Name:KATHRYN
Middle Name:AIMEE REBECCA
Last Name:JAMES
Suffix:
Gender:F
Credentials:MFT 46494
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 PACIFIC AVE # 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1545
Mailing Address - Country:US
Mailing Address - Phone:415-244-5590
Mailing Address - Fax:510-521-7145
Practice Address - Street 1:2000 VAN NESS AVE STE 216
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3021
Practice Address - Country:US
Practice Address - Phone:415-244-5590
Practice Address - Fax:510-521-7145
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46494106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist