Healthcare Provider Details

I. General information

NPI: 1184880601
Provider Name (Legal Business Name): KERI KATHLEEN OLRICH MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KERI KATHLEEN STRICKLAND MA

II. Dates (important events)

Enumeration Date: 08/04/2008
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 BUTTERFIELD RD
SAN ANSELMO CA
94960-1067
US

IV. Provider business mailing address

1317 BUTTERFIELD RD
SAN ANSELMO CA
94960-1067
US

V. Phone/Fax

Practice location:
  • Phone: 415-999-9999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number40135
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: