1548454846 NPI number — FELICITE KATTAN BARTON LMFT

Table of content: FELICITE KATTAN BARTON LMFT (NPI 1548454846)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548454846 NPI number — FELICITE KATTAN BARTON LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARTON
Provider First Name:
FELICITE
Provider Middle Name:
KATTAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548454846
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/29/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 OYSTER BLVD.
Provider Second Line Business Mailing Address:
SUITE 501
Provider Business Mailing Address City Name:
SOUTH SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94080-1904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-866-4080
Provider Business Mailing Address Fax Number:
650-866-4081

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1838 EASTMAN AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
VENTURA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93003-6496
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-289-0120
Provider Business Practice Location Address Fax Number:
805-289-0130
Provider Enumeration Date:
08/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFC 25316 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 56CC . This is a "SHORT DOYLE PROVIDER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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