Healthcare Provider Details

I. General information

NPI: 1518071679
Provider Name (Legal Business Name): KARI ANN HANSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. KARI ANN VANBRAKLE

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8928 VOLUNTEER LN STE 100
SACRAMENTO CA
95826-3238
US

IV. Provider business mailing address

300 GOBBI STREET
UKIAH CA
95482
US

V. Phone/Fax

Practice location:
  • Phone: 707-707-5336
  • Fax:
Mailing address:
  • Phone: 916-509-1754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number67916
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number123228
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number67916
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number123228
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: