Provider Demographics
NPI:1417229717
Name:GUTHRIE, MASAKO (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MASAKO
Middle Name:
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-2549
Mailing Address - Country:US
Mailing Address - Phone:510-665-4118
Mailing Address - Fax:510-548-4119
Practice Address - Street 1:3041 TREMONT ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-2549
Practice Address - Country:US
Practice Address - Phone:510-665-4118
Practice Address - Fax:510-548-4119
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43333106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist