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NPI Code Detail

MEDICARE: KATHARINE CRUZ MFT

MEDICARE: KATHARINE CRUZ 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
1106H00000XMarriage & Family Therapist101106CA

General Provider Information

NPI Number : 1619587219
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHARINE CRUZ MFT
Provider Business Mailing Address
First Line : PO BOX 5182
Second Line :
City : BERKELEY
State : CA
Zip : 94705-0182
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3010 COLBY ST STE 221
Second Line :
City : BERKELEY
State : CA
Zip : 94705-2056
Country : US
Telephone Number : 510-922-9757
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2020
Last Update Date : 11/17/2020

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Directions to “ KATHARINE CRUZ MFT” Practice Location

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