Provider Demographics
NPI:1053761130
Name:HAZARD, KATHLEEN PRICE (PPS, AMFT)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:PRICE
Last Name:HAZARD
Suffix:
Gender:F
Credentials:PPS, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7125 DONAL AVE
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-2403
Mailing Address - Country:US
Mailing Address - Phone:510-231-1449
Mailing Address - Fax:
Practice Address - Street 1:7125 DONAL AVE
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-2403
Practice Address - Country:US
Practice Address - Phone:510-231-1449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool