Provider Demographics
NPI:1518124395
Name:KOKATAY, ALICE IRENE (MFT)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:IRENE
Last Name:KOKATAY
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 1:5625 W CAMINO CIELO
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-9706
Mailing Address - Country:US
Mailing Address - Phone:805-280-9941
Mailing Address - Fax:
Practice Address - Street 1:5625 W CAMINO CIELO
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-9706
Practice Address - Country:US
Practice Address - Phone:805-280-9941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37733106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC37733OtherMARRIAGE, FAMILY THERAPIST LICENSE