Provider Demographics
NPI:1427074160
Name:KIATTA, THOMAS E (MFT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:E
Last Name:KIATTA
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 W ALISAL ST
Mailing Address - Street 2:# 2
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2719
Mailing Address - Country:US
Mailing Address - Phone:831-422-1162
Mailing Address - Fax:831-422-2304
Practice Address - Street 1:60 W ALISAL ST
Practice Address - Street 2:# 2
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2719
Practice Address - Country:US
Practice Address - Phone:831-422-1162
Practice Address - Fax:831-422-2304
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 14034106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist