Baniwas, Kathleen

Baniwas, Kathleen is an individual health care provider with primary practice located at 780 Shadowridge Dr , Vista CA 92083-7986. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Baniwas, Kathleen can be contacted via phone (760) 599-2471.

Contact Information

Primary practice address
780 Shadowridge Dr Vista CA 92083-7986
Phone: (760) 599-2471
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X IMF89556 California
Behavioral Health & Social Service Providers / Clinical 1041C0700X 107813 California

Profile Details

NPI number 1710339650
LBN Legal business name Baniwas, Kathleen
Credentials LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2016
Last updated Nov 19th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710339650 NPPES
California Other 95-2633765 MEDI-CAL

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