Provider Demographics
NPI:1568685410
Name:PARRISH, KATHLEEN II
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:PARRISH
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33480 AVE. 9
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636
Mailing Address - Country:US
Mailing Address - Phone:559-453-8922
Mailing Address - Fax:
Practice Address - Street 1:33480 AVENUE 9
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-7948
Practice Address - Country:US
Practice Address - Phone:559-453-8922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 13481101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health