MEDICARE: MS. KATHLEEN PRICE HAZARD PPS, AMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist
2	101Y00000X	Counselor
3	103TS0200X	School Psychologist	250084520	CA

General Provider Information

NPI Number	:	1053761130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN PRICE HAZARD PPS, AMFT

Provider Business Mailing Address
First Line	:	7125 DONAL AVE
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-2403
Country	:	US
Telephone Number	:	510-231-1449
Fax Number	:

Provider Business Practice Location Address
First Line	:	7125 DONAL AVE
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-2403
Country	:	US
Telephone Number	:	510-231-1449
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2016
Last Update Date	:	05/06/2026

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