Provider Information for 1114075330
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JONATHAN KLEV KABAT LMFT
Sex: Male
NPI: 1114075330
Last Updated: 2023-03-21
Certification Date: 2023-03-21
Certification Date: 2023-03-21
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1114075330 | ||||||||||||
| Enumeration Date | 2007-01-05 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 595 WEED, CA 96094-0595 United States Phone: 415-630-2305 | Fax: | ||||||||||||
| Primary Practice Address | 150 NELLEN AVE SUITE 100 CORTE MADERA, CA 94925-1104 United States Phone: 415-567-4604 | Fax: | ||||||||||||
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