Provider Demographics
NPI:1396545943
Name:HARGAN, KATHLEEN M (LMFT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:HARGAN
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 1815
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-4815
Mailing Address - Country:US
Mailing Address - Phone:510-421-1254
Mailing Address - Fax:
Practice Address - Street 1:1126 E 3RD ST
Practice Address - Street 2:
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-3438
Practice Address - Country:US
Practice Address - Phone:510-421-1254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT36676101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health