Provider Demographics
NPI:1093843625
Name:KITZ, BARBARA S (MFT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:S
Last Name:KITZ
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 FORTUNE COURT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602
Mailing Address - Country:US
Mailing Address - Phone:530-305-9267
Mailing Address - Fax:530-889-2420
Practice Address - Street 1:3215 FORTUNE COURT
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-9245
Practice Address - Country:US
Practice Address - Phone:530-305-9267
Practice Address - Fax:530-889-2420
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 24502106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9534OtherPLACER CO. PROVIDER NO.