Provider Demographics
NPI:1265763825
Name:COFFRON, KATHERINA ELIZABETH (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:KATHERINA
Middle Name:ELIZABETH
Last Name:COFFRON
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 PINE ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-2213
Mailing Address - Country:US
Mailing Address - Phone:805-975-8399
Mailing Address - Fax:
Practice Address - Street 1:1244 PINE ST
Practice Address - Street 2:SUITE 203
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-2213
Practice Address - Country:US
Practice Address - Phone:805-975-8399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50027106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist