Provider Demographics
NPI:1972169316
Name:DENNIS, KATHY E (LMFT)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:E
Last Name:DENNIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2911
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29484-2911
Mailing Address - Country:US
Mailing Address - Phone:760-884-4929
Mailing Address - Fax:
Practice Address - Street 1:502 W EL NORTE PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-3983
Practice Address - Country:US
Practice Address - Phone:760-884-4929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141355106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist