Provider Demographics
NPI:1124502281
Name:PRATE, KALEENA E (LMFT)
Entity type:Individual
Prefix:
First Name:KALEENA
Middle Name:E
Last Name:PRATE
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 1:43211 CINCO ARROYOS
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-8043
Mailing Address - Country:US
Mailing Address - Phone:310-482-1401
Mailing Address - Fax:
Practice Address - Street 1:43211 CINCO ARROYOS
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-8043
Practice Address - Country:US
Practice Address - Phone:310-482-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85087106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist