Provider Demographics
NPI:1316368558
Name:KATHRYN TULL INC
Entity Type:Organization
Organization Name:KATHRYN TULL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:TULL
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LMFT
Authorized Official - Phone:310-920-9480
Mailing Address - Street 1:3760 MOTOR AVE STE 315
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-6404
Mailing Address - Country:US
Mailing Address - Phone:310-920-9480
Mailing Address - Fax:310-204-5030
Practice Address - Street 1:3760 MOTOR AVE STE 315
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-6404
Practice Address - Country:US
Practice Address - Phone:310-920-9480
Practice Address - Fax:310-204-5030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44809106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty