Basic Information
| Provider Information | |||||||||
| NPI: | 1679059109 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | ACSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 557 JOAN CT | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953402412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2097610729 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3360 N HIGHWAY 59 STE K | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953489405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2097252125 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2018 | ||||||||
| LastUpdateDate: | 09/19/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 90725 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.