Provider Demographics
NPI:1902237639
Name:CHILCOTE, KARA (LMFT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:CHILCOTE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 UTAH ST STE F
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-2939
Mailing Address - Country:US
Mailing Address - Phone:619-994-0773
Mailing Address - Fax:
Practice Address - Street 1:2525 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 245
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3717
Practice Address - Country:US
Practice Address - Phone:619-994-0773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-05
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist