Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 103TS0200X | School Psychologist |
NPI | 1053761130 |
---|---|
Provider Name | Ms. Kathleen Price Hazard |
First Address | El Cerrito, CA 94530-2403 |
Second Address | El Cerrito, CA 94530-2403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2016 |
Last Update Date | 22/04/2019 |