Provider Demographics
NPI:1073839650
Name:COMFORT, KATHARINE MICHELE
Entity Type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:MICHELE
Last Name:COMFORT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3918
Mailing Address - Country:US
Mailing Address - Phone:650-224-0132
Mailing Address - Fax:
Practice Address - Street 1:1306 KENTFIELD AVE
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-2779
Practice Address - Country:US
Practice Address - Phone:650-224-0132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA131913101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health