Provider Demographics
NPI:1083043541
Name:TAING, KATHLEEN MILLER (LMFT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MILLER
Last Name:TAING
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:PANTOJA
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFTI
Mailing Address - Street 1:8607 FLANDERS DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-3248
Mailing Address - Country:US
Mailing Address - Phone:858-610-3518
Mailing Address - Fax:
Practice Address - Street 1:6244 EL CAJON BLVD
Practice Address - Street 2:#14
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-3918
Practice Address - Country:US
Practice Address - Phone:619-640-3266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA143134106H00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health