Provider Demographics
NPI:1639385529
Name:HALPERN, KATRINA A
Entity Type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:A
Last Name:HALPERN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:TIA
Other - Middle Name:A
Other - Last Name:HALPERN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:722 ASHBURY AVE
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3248
Mailing Address - Country:US
Mailing Address - Phone:510-527-8160
Mailing Address - Fax:
Practice Address - Street 1:2252 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2222
Practice Address - Country:US
Practice Address - Phone:415-541-5038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 18801103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical