Provider Demographics
NPI:1619012473
Name:WYLER, KATHRYN MARGARET (MFT)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:MARGARET
Last Name:WYLER
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 1:1080 CAROL LN STE 280
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4759
Mailing Address - Country:US
Mailing Address - Phone:925-286-2895
Mailing Address - Fax:925-247-5493
Practice Address - Street 1:1080 CAROL LN STE 280
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4759
Practice Address - Country:US
Practice Address - Phone:925-286-2895
Practice Address - Fax:925-247-5493
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46628106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist