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General NPI Number Information
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NPI Number | 1538439963
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Entity Type | Individual
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Provider Name | KAIA MICHELLE KORDIC M.S., LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/02/2012
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 537 G ST STE 200
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City | EUREKA
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State | CA
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Zip | 95501
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Country | US
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Telephone | 707-298-9801
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Fax |
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Provider Business Mailing Address
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Address Line | 537 G ST STE 200
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City | EUREKA
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State | CA
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Zip | 95501-1043
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Country | US
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Telephone | 707-298-9801
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFTI #76115
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 95522
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License Number State | CA
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