Provider Demographics
NPI:1447325766
Name:ENGLIN, KATHRYN A (MFT)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:A
Last Name:ENGLIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:KATHRYN
Other - Middle Name:A
Other - Last Name:SHAINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2830 G STREET SUITE D
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-4447
Mailing Address - Country:US
Mailing Address - Phone:707-441-4803
Mailing Address - Fax:707-442-4545
Practice Address - Street 1:2830 G STREET SUITE D
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-4447
Practice Address - Country:US
Practice Address - Phone:707-441-4803
Practice Address - Fax:707-442-4545
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC20014106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist