Provider Demographics
NPI:1316226525
Name:PAULEY, KATHY ANN (MA MFT)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:ANN
Last Name:PAULEY
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26209 DOUGLASS UNION LN
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-4087
Mailing Address - Country:US
Mailing Address - Phone:951-249-9230
Mailing Address - Fax:951-249-9230
Practice Address - Street 1:29748 RANCHO CALIFORNIA RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5286
Practice Address - Country:US
Practice Address - Phone:951-694-0695
Practice Address - Fax:951-695-6215
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC47833106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist