Provider Demographics
NPI:1992870372
Name:PRATHER, KERI MARIE (LMFT)
Entity type:Individual
Prefix:MISS
First Name:KERI
Middle Name:MARIE
Last Name:PRATHER
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 1:2000 IPSEN WAY
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-1814
Mailing Address - Country:US
Mailing Address - Phone:714-931-2230
Mailing Address - Fax:
Practice Address - Street 1:305 N HARBOR BLVD STE 215
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1901
Practice Address - Country:US
Practice Address - Phone:714-932-9520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50823106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist