Kathleen Marie Dodge, MFT
Individual provider Active NPI Marriage & Family Therapist · Pacifica, CA
NPI 1306258595 · NPPES record last updated Sep 29, 2023
Key facts
- NPI
- 1306258595
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- IMF 66263 (CA)
- Practice address
- 243 Arroyo Drive
Pacifica, CA 94044 - Phone
- (650) 278-7524
- NPI assigned
- May 22, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 66263 | CA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF 66263 | CA | Yes |
Addresses
Primary practice location
243 Arroyo Drive
Pacifica, CA 94044
Mailing address
243 Arroyo Dr
Pacifica, CA 94044-2302
Phone (650) 278-7524
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All providers in Pacifica, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.