MEDICARE: KATHRYN ALISON WEBB LMFT ATR-BC

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	101YP2500X	Professional Counselor	MFT24190	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MFT24190	OTHER	CA	LMFT LICENSE

General Provider Information

NPI Number	:	1861660763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN ALISON WEBB LMFT ATR-BC

Provider Business Mailing Address
First Line	:	2400 KETTNER BLVD
Second Line	:	SUITE 221
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-1249
Country	:	US
Telephone Number	:	619-231-4278
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 KETTNER BLVD
Second Line	:	SUITE 221
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-1249
Country	:	US
Telephone Number	:	619-231-4278
Fax Number	:

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

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	02/13/2008

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