Healthcare Provider Details

I. General information

NPI: 1407637911
Provider Name (Legal Business Name): CLIFFORD KUHN-LLOYD AMFT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32670 HIGHWAY 20 UNIT 2
FORT BRAGG CA
95437-5708
US

IV. Provider business mailing address

PO BOX 2077
UKIAH CA
95482-2077
US

V. Phone/Fax

Practice location:
  • Phone: 707-467-2010
  • Fax:
Mailing address:
  • Phone: 707-467-2010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: