Provider Demographics
NPI:1598286460
Name:STREETER, KATHLEEN FLORENCE (MA, MFT INTERN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:FLORENCE
Last Name:STREETER
Suffix:
Gender:F
Credentials:MA, MFT INTERN
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:FLORENCE
Other - Last Name:BEBOUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 FIGUEROA ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-2756
Mailing Address - Country:US
Mailing Address - Phone:805-794-4755
Mailing Address - Fax:
Practice Address - Street 1:500 HIGH POINT DR
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1410
Practice Address - Country:US
Practice Address - Phone:805-644-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist