Provider Demographics
NPI:1932269826
Name:VROOMEN, KATHRYN (MFT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:VROOMEN
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:PO BOX 66242
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95067-6242
Mailing Address - Country:US
Mailing Address - Phone:831-460-9135
Mailing Address - Fax:831-461-9700
Practice Address - Street 1:4113 SCOTTS VALLEY DR
Practice Address - Street 2:SUITE 104
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066-4547
Practice Address - Country:US
Practice Address - Phone:831-460-9135
Practice Address - Fax:831-461-9700
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42528101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional