Healthcare Provider Details

I. General information

NPI: 1639918501
Provider Name (Legal Business Name): COLVIN MARIAH KUHN AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2024
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 ALAMO PINTADO RD STE 103
SOLVANG CA
93463-2266
US

IV. Provider business mailing address

136 LOVELL AVE
MILL VALLEY CA
94941-1835
US

V. Phone/Fax

Practice location:
  • Phone: 415-827-4847
  • Fax:
Mailing address:
  • Phone: 415-827-4847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number144649
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: