Provider Demographics
NPI:1639489982
Name:BARKER, KATHLEEN CAROLINE (LMFT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:CAROLINE
Last Name:BARKER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:CAROLINE
Other - Last Name:HEGGUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:6950 65TH STREET
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823
Mailing Address - Country:US
Mailing Address - Phone:916-393-1222
Mailing Address - Fax:916-567-4220
Practice Address - Street 1:6950 65TH STREET
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823
Practice Address - Country:US
Practice Address - Phone:916-393-1222
Practice Address - Fax:916-567-4220
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48503106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist