Provider Demographics
NPI:1538261433
Name:CASHMAN, KATHLEEN (MFT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:CASHMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5741 JAMIESON AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1043
Mailing Address - Country:US
Mailing Address - Phone:818-757-1166
Mailing Address - Fax:818-757-1193
Practice Address - Street 1:5741 JAMIESON AVE
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1043
Practice Address - Country:US
Practice Address - Phone:818-757-1166
Practice Address - Fax:818-757-1193
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT337400106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ54219ZOtherBLUE SHIELD PROVIDER
CAMFT337400OtherMFT LICENSE