Provider Demographics
NPI:1568264422
Name:SPENCER, KATHARINE C
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:C
Last Name:SPENCER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 KIPLING DR
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1575
Mailing Address - Country:US
Mailing Address - Phone:415-360-4193
Mailing Address - Fax:
Practice Address - Street 1:384 BEL MARIN KEYS BLVD
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-5361
Practice Address - Country:US
Practice Address - Phone:415-444-5580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist