Provider Demographics
NPI:1154522142
Name:ZECHMEISTER, KATHLEEN M (MFT)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:M
Last Name:ZECHMEISTER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:KATHLEEN
Other - Middle Name:M
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5658 E DEBORAH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1134
Mailing Address - Country:US
Mailing Address - Phone:562-425-3242
Mailing Address - Fax:562-596-8901
Practice Address - Street 1:5658 E DEBORAH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1134
Practice Address - Country:US
Practice Address - Phone:562-425-3242
Practice Address - Fax:562-596-8901
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT25968106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFT25968OtherLICENSE