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General NPI Number Information
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NPI Number | 1447640420
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Entity Type | Individual
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Provider Name | KAYLA HABERERN M.A.
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Gender | Female
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 04/25/2022
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Provider Practice Location Address
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Address Line | 2261 BRYANT ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-2833
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Country | US
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Telephone | 415-762-3700
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Fax | 415-865-0119
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Provider Business Mailing Address
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Address Line | 1563 MISSION ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94103-2543
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Country | US
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Telephone | 415-762-3700
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Fax | 415-865-0119
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPCC11334
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License Number State | CA
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