Provider Demographics
NPI:1659465557
Name:BOYD, KATHLEEN RACHEL (MFT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:RACHEL
Last Name:BOYD
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 1:1434 THIRD ST STE 2D
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2860
Mailing Address - Country:US
Mailing Address - Phone:707-694-2844
Mailing Address - Fax:
Practice Address - Street 1:1434 THIRD ST STE 2D
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2860
Practice Address - Country:US
Practice Address - Phone:707-694-2844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35267106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist