Provider Demographics
NPI:1750432944
Name:KEPNER, ALAN (MFT)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:KEPNER
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PROFESSIONAL CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94947-4369
Mailing Address - Country:US
Mailing Address - Phone:415-898-9015
Mailing Address - Fax:415-257-4602
Practice Address - Street 1:200 PROFESSIONAL CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-4369
Practice Address - Country:US
Practice Address - Phone:415-898-9015
Practice Address - Fax:415-257-4602
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC14032106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist