Provider Demographics
NPI:1346314705
Name:CUTTER, KATHLEEN HIATT (LAC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:HIATT
Last Name:CUTTER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:28 DURHAM RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-1605
Mailing Address - Country:US
Mailing Address - Phone:415-847-9990
Mailing Address - Fax:415-459-2648
Practice Address - Street 1:700 E ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-2762
Practice Address - Country:US
Practice Address - Phone:415-847-9990
Practice Address - Fax:415-419-2120
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 2799171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist