Provider Demographics
NPI:1104035765
Name:DAILEY, KATHI (LMFT)
Entity Type:Individual
Prefix:
First Name:KATHI
Middle Name:
Last Name:DAILEY
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 1:985 OUTRIGGER CIR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5441
Mailing Address - Country:US
Mailing Address - Phone:925-634-9970
Mailing Address - Fax:
Practice Address - Street 1:234 OAK ST STE 9
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-1340
Practice Address - Country:US
Practice Address - Phone:925-513-2779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 30799106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist