Provider Demographics
NPI:1841404845
Name:KEST, DAVID J (MFT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:KEST
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 BOLLING CIRCLE
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949
Mailing Address - Country:US
Mailing Address - Phone:415-455-9029
Mailing Address - Fax:415-455-9029
Practice Address - Street 1:1000 5TH AVE
Practice Address - Street 2:8
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-6104
Practice Address - Country:US
Practice Address - Phone:415-455-9029
Practice Address - Fax:415-455-9029
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC-30578106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist