Provider Demographics
NPI:1659732956
Name:GEENEN, KAITLIN (MFT)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:GEENEN
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 1:400 MAIN ST STE 220
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7371
Mailing Address - Country:US
Mailing Address - Phone:415-364-8231
Mailing Address - Fax:
Practice Address - Street 1:400 MAIN ST STE 220
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7371
Practice Address - Country:US
Practice Address - Phone:415-364-8231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-14
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84274106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist