Healthcare Provider Details

I. General information

NPI: 1831324987
Provider Name (Legal Business Name): KATHY L. GELEIN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 05/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 SUNRISE AVE STE A19
ROSEVILLE CA
95661-4558
US

IV. Provider business mailing address

901 SUNRISE AVE STE A19
ROSEVILLE CA
95661-4558
US

V. Phone/Fax

Practice location:
  • Phone: 916-804-6471
  • Fax:
Mailing address:
  • Phone: 916-804-6471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number36789
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: