Provider Demographics
NPI:1487844676
Name:HALLFORD, KATHRYN INEZ (RADI)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:INEZ
Last Name:HALLFORD
Suffix:
Gender:F
Credentials:RADI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8172 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-3441
Mailing Address - Country:US
Mailing Address - Phone:951-687-9922
Mailing Address - Fax:951-352-7374
Practice Address - Street 1:8310 BAXTER WAY
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-4302
Practice Address - Country:US
Practice Address - Phone:951-689-9366
Practice Address - Fax:951-352-7374
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)