Provider Demographics
NPI:1467870071
Name:BROWN, KATHRYN JANE (LMFT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:JANE
Last Name:BROWN
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 1:130 NANTUCKET LN
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-5890
Mailing Address - Country:US
Mailing Address - Phone:925-200-6850
Mailing Address - Fax:
Practice Address - Street 1:130 NANTUCKET LN
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5890
Practice Address - Country:US
Practice Address - Phone:925-200-6850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53611106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist