Kathleen Diane Abbadessa, MFT

Individual provider Active NPI Marriage & Family Therapist · Santa Rosa, CA

NPI 1821202102 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1821202102
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFC36266 (CA)
Practice address
625 Cherry St
Ste 5
Santa Rosa, CA 95404-4202
Phone
(707) 523-6433
Fax
(707) 539-2994
NPI assigned
May 9, 2007
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

LicenseStateTypeSpecialty
MFC36266CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC36266 CA Yes

Addresses

Primary practice location

625 Cherry St
Ste 5
Santa Rosa, CA 95404-4202

Mailing address

625 Cherry St
Ste 5
Santa Rosa, CA 95404-4202
Phone (707) 523-6433

Other providers in Santa Rosa, CA

All providers in Santa Rosa, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.