Provider Demographics
NPI:1548647522
Name:MULHOLLAND, KATHRYN (PHD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:MULHOLLAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2269 CHESTNUT ST
Mailing Address - Street 2:#184
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-2600
Mailing Address - Country:US
Mailing Address - Phone:415-407-4029
Mailing Address - Fax:
Practice Address - Street 1:2269 CHESTNUT ST
Practice Address - Street 2:#184
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-2600
Practice Address - Country:US
Practice Address - Phone:415-407-4029
Practice Address - Fax:415-674-3855
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27104103TC0700X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation