Provider Demographics
NPI:1225076367
Name:KINCAID, MARGARET GRACE (MFT)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:GRACE
Last Name:KINCAID
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:
Other - Last Name:KINCAID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:4283 PIEDMONT AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-4758
Mailing Address - Country:US
Mailing Address - Phone:510-658-3247
Mailing Address - Fax:
Practice Address - Street 1:4283 PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4758
Practice Address - Country:US
Practice Address - Phone:510-658-3247
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT24983101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist