Provider Demographics
NPI:1881159382
Name:EMBODY, KATHERINE SINCLAIR (LMFT 154651)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SINCLAIR
Last Name:EMBODY
Suffix:
Gender:
Credentials:LMFT 154651
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 HACIENDA ST
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-4366
Mailing Address - Country:US
Mailing Address - Phone:650-539-0340
Mailing Address - Fax:650-319-9733
Practice Address - Street 1:3701 HACIENDA ST
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-4366
Practice Address - Country:US
Practice Address - Phone:650-539-0340
Practice Address - Fax:650-319-9733
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA154651106H00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist