Provider Demographics
NPI:1912057167
Name:MCGREGOR, KATHERINE LILLIAN (LMFT MFC 36052)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LILLIAN
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:LMFT MFC 36052
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1989 VICENTE DR
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-6863
Mailing Address - Country:US
Mailing Address - Phone:805-781-4314
Mailing Address - Fax:805-781-4212
Practice Address - Street 1:1989 VICENTE DR
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-6863
Practice Address - Country:US
Practice Address - Phone:805-781-4314
Practice Address - Fax:805-781-4212
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 36052106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist