Provider Demographics
NPI:1922435494
Name:MOORHEAD, KATHERINE GREENAWAY (MS LMFT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:GREENAWAY
Last Name:MOORHEAD
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:GREENAWAY
Other - Last Name:TERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS LMFT
Mailing Address - Street 1:321 CASSIDY ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-5314
Mailing Address - Country:US
Mailing Address - Phone:760-721-2170
Mailing Address - Fax:
Practice Address - Street 1:321 CASSIDY ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5314
Practice Address - Country:US
Practice Address - Phone:760-721-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73278106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist