Provider Demographics
NPI:1538326160
Name:JABLONSKI, KATHLLEN MARY (LMFT)
Entity Type:Individual
Prefix:
First Name:KATHLLEN
Middle Name:MARY
Last Name:JABLONSKI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:J
Other - Last Name:SHEFFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:202 PROVIDENCE MINE RD
Mailing Address - Street 2:SUITE 103F
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-2947
Mailing Address - Country:US
Mailing Address - Phone:530-265-2202
Mailing Address - Fax:530-362-4095
Practice Address - Street 1:202 PROVIDENCE MINE RD
Practice Address - Street 2:SUITE 103F
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2947
Practice Address - Country:US
Practice Address - Phone:530-265-2202
Practice Address - Fax:530-362-4095
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT45680106H00000X
CA45680101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist