Provider Demographics
NPI:1548960636
Name:WEIDKAMP, SENA KATHERINE (LMFT)
Entity type:Individual
Prefix:MS
First Name:SENA
Middle Name:KATHERINE
Last Name:WEIDKAMP
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 1:1934 ASCOT DR
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-1449
Mailing Address - Country:US
Mailing Address - Phone:510-915-0914
Mailing Address - Fax:
Practice Address - Street 1:1415 OAKLAND BLVD STE 203
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4395
Practice Address - Country:US
Practice Address - Phone:925-378-9456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA146004101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health