Provider Demographics
NPI:1093498594
Name:KUBRICKY, KATHLEEN YOKO (LMFT)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:YOKO
Last Name:KUBRICKY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 WOODSIDE RD UNIT 620769
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:94062-7317
Mailing Address - Country:US
Mailing Address - Phone:650-398-7372
Mailing Address - Fax:
Practice Address - Street 1:295 OLD COUNTY RD STE 6
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-6240
Practice Address - Country:US
Practice Address - Phone:650-398-7372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA92794106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty