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NPI Code Detail

MEDICARE: KATHARINE LUCRETIA WATERS

MEDICARE: KATHARINE LUCRETIA WATERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist125478TX
2225X00000XOccupational Therapist09901MD
3225X00000XOccupational Therapist0119010697VA
4106S00000XBehavior TechnicianMD

General Provider Information

NPI Number : 1316413362
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHARINE LUCRETIA WATERS
Provider Business Mailing Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 10015 OLD COLUMBIA RD STE F100
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-1755
Country : US
Telephone Number : 443-741-8788
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2018
Last Update Date : 02/02/2026

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Directions to “ KATHARINE LUCRETIA WATERS ” Practice Location

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