Provider Demographics
NPI:1881920262
Name:SERVICE, KITTIE KINSEY T (PHD, MFT)
Entity type:Individual
Prefix:DR
First Name:KITTIE KINSEY
Middle Name:T
Last Name:SERVICE
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 VEREDA DEL CIERVO
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-5337
Mailing Address - Country:US
Mailing Address - Phone:805-685-9262
Mailing Address - Fax:805-685-6065
Practice Address - Street 1:861 VEREDA DEL CIERVO
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-5337
Practice Address - Country:US
Practice Address - Phone:805-685-9262
Practice Address - Fax:805-685-6065
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46309106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist