Provider Demographics
NPI:1114075330
Name:KABAT, JONATHAN KLEV (LMFT)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:KLEV
Last Name:KABAT
Suffix:
Gender:M
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:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:WEED
Mailing Address - State:CA
Mailing Address - Zip Code:96094-0595
Mailing Address - Country:US
Mailing Address - Phone:415-630-2305
Mailing Address - Fax:
Practice Address - Street 1:150 NELLEN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1104
Practice Address - Country:US
Practice Address - Phone:415-567-4604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF88779106H00000X
CA129217106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist