Provider Demographics
NPI:1811326010
Name:KAHAN, CINDY ANN (MFT)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:ANN
Last Name:KAHAN
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 1:55 PARK WAY
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94611-3928
Mailing Address - Country:US
Mailing Address - Phone:510-507-1944
Mailing Address - Fax:
Practice Address - Street 1:55 PARK WAY
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:CA
Practice Address - Zip Code:94611-3928
Practice Address - Country:US
Practice Address - Phone:510-507-1944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT31344106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist