Provider Demographics
NPI:1457605693
Name:VIRET, KATHERINE (MFT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:VIRET
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 HAMILTON AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2010
Mailing Address - Country:US
Mailing Address - Phone:650-996-7960
Mailing Address - Fax:650-494-4669
Practice Address - Street 1:550 HAMILTON AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2010
Practice Address - Country:US
Practice Address - Phone:650-996-7960
Practice Address - Fax:650-494-4669
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48608106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist