Provider Demographics
NPI:1518015791
Name:PAULUS, CAROLYN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:
Last Name:PAULUS
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 1:2920 CAMINO DIABLO STE 160
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3982
Mailing Address - Country:US
Mailing Address - Phone:925-264-1188
Mailing Address - Fax:
Practice Address - Street 1:2920 CAMINO DIABLO STE 160
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-3982
Practice Address - Country:US
Practice Address - Phone:925-264-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 40895106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist