Provider Demographics
NPI:1306593686
Name:FARRINGTON, KATHLEEN ANN (RADT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:FARRINGTON
Suffix:
Gender:F
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DAAC CENTERPOINT
Mailing Address - Street 2:2403 PROFESSIONAL DR. STE. 102
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95403
Mailing Address - Country:US
Mailing Address - Phone:415-454-9444
Mailing Address - Fax:
Practice Address - Street 1:DAAD CENTERPOINT
Practice Address - Street 2:2403 PROFESSIONAL DR. STE. 102
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:95403
Practice Address - Country:US
Practice Address - Phone:415-454-9444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor