Provider Demographics
NPI:1326338351
Name:MARASHIAN, KATHERINE JANE (LMFT 112436)
Entity Type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:JANE
Last Name:MARASHIAN
Suffix:
Gender:F
Credentials:LMFT 112436
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:JANE
Other - Last Name:MARASHIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:530 OCEAN ST STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-6628
Mailing Address - Country:US
Mailing Address - Phone:831-459-0444
Mailing Address - Fax:888-971-7195
Practice Address - Street 1:530 OCEANT ST
Practice Address - Street 2:SUITE B
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060
Practice Address - Country:US
Practice Address - Phone:831-459-0444
Practice Address - Fax:888-971-7195
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
98213106H00000X
CA112436106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4424Medicaid