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Individual
KATHLEEN BANIWAS
Active
Individual
KATHLEEN BANIWAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
107813
CA
106H00000X
Marriage & Family Therapist
IMF89556
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
07/04/2016
Last updated
11/19/2021
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