Provider Demographics
NPI:1942747647
Name:WHITSON, KARI ALTHEA (MFT, PPS, NCC)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:ALTHEA
Last Name:WHITSON
Suffix:
Gender:F
Credentials:MFT, PPS, NCC
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:ALTHEA
Other - Last Name:WHITSON-WILSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT, PPS, NCC
Mailing Address - Street 1:PO BOX 2572
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93423-2572
Mailing Address - Country:US
Mailing Address - Phone:805-762-4838
Mailing Address - Fax:
Practice Address - Street 1:10845 SAN MARCOS RD
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-2170
Practice Address - Country:US
Practice Address - Phone:559-972-4533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT95993106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist