Healthcare Provider Details

I. General information

NPI: 1053761130
Provider Name (Legal Business Name): KATHLEEN PRICE HAZARD PPS, AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7125 DONAL AVE
EL CERRITO CA
94530-2403
US

IV. Provider business mailing address

7125 DONAL AVE
EL CERRITO CA
94530-2403
US

V. Phone/Fax

Practice location:
  • Phone: 510-231-1449
  • Fax:
Mailing address:
  • Phone: 510-231-1449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number250084520
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: