Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY27104 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY27104 | CA |
N | 103TR0400X | Rehabilitation Psychologist | PSY27104 | CA |
NPI | 1548647522 |
---|---|
Provider Name | Kathryn Mulholland |
First Address | San Francisco, CA 94123-2600 |
Second Address | San Francisco, CA 94123-2600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2015 |
Last Update Date | 29/04/2015 |