Provider Demographics
NPI:1396849402
Name:CHANDLER-KLEIN, CATHY (MFT)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:
Last Name:CHANDLER-KLEIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-4829
Mailing Address - Country:US
Mailing Address - Phone:707-443-8302
Mailing Address - Fax:707-331-1282
Practice Address - Street 1:2625 WILSON ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503
Practice Address - Country:US
Practice Address - Phone:707-845-0143
Practice Address - Fax:707-331-1282
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22806106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist