Kathryn Elizabeth Bullick, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

136292 Issued in CA

Practice address

3099 Telegraph Ave
Berkeley, CA 94705-2035

Phone

(510) 306-2207

NPI assigned

Feb 9, 2023

Last updated

Feb 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 15, 2024 through Jan 15, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1043917131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 OPAL ST APT 6",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092684",
            "telephone_number": "925-819-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3099 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052035",
            "telephone_number": "510-306-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLICK",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "136292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Building Opportunities for Self-Sufficiency
• Building Opportunities for Self-Sufficiency
• Building Opportunities for Self-Sufficiency
• Building Opportunities for Self-Sufficiency
• Syeda Bukhari, FNP
• Beverly Burch
• Kim Tran Burdick, O.D.
• Erin Bures, RN, BSN
• Dennis Stuart Burger, O.D.
• Olivia Ryan Burger, OD

• Marriage & Family Therapist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.