MEDICARE: DR. PAUL EDWARD KATZ MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MZ18394	CA

General Provider Information

NPI Number	:	1295840858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL EDWARD KATZ MFT

Provider Business Mailing Address
First Line	:	230 FAIRLAWN DR
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94708-2110
Country	:	US
Telephone Number	:	510-913-1538
Fax Number	:	510-848-8778

Provider Business Practice Location Address
First Line	:	2006 DWIGHT WAY STE 101
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704-2633
Country	:	US
Telephone Number	:	510-913-1538
Fax Number	:	510-848-8778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	07/08/2007

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