Provider Demographics
NPI:1659533743
Name:BUTLER, KATHERINE EMERSON (MFT)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:EMERSON
Last Name:BUTLER
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 1:2715 PORTER ST
Mailing Address - Street 2:ROOM 209
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-2458
Mailing Address - Country:US
Mailing Address - Phone:831-464-8541
Mailing Address - Fax:831-426-3241
Practice Address - Street 1:2715 PORTER ST
Practice Address - Street 2:ROOM 209
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2458
Practice Address - Country:US
Practice Address - Phone:831-464-8541
Practice Address - Fax:831-426-3241
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28303106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist