Provider Demographics
NPI:1750832184
Name:WHITTLE-UTTER, KATHARINE (MA, MFT)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:WHITTLE-UTTER
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:WHITTLE-UTTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, MFT
Mailing Address - Street 1:1346 PISMO ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-3322
Mailing Address - Country:US
Mailing Address - Phone:626-840-9031
Mailing Address - Fax:
Practice Address - Street 1:560 HIGUERA ST STE H
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3804
Practice Address - Country:US
Practice Address - Phone:626-840-9031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95757106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist