Basic Information
| Provider Information | |||||||||
| NPI: | 1881733582 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VILCHEZ | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | ANNA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1743 BREA BLVD | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928353918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099029111 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1490 N CLAREMONT BLVD | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | CLAREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917113519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7147466047 | ||||||||
| FaxNumber: | 9098337195 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2007 | ||||||||
| LastUpdateDate: | 11/16/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC39770 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.