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NPI Code Detail

MEDICARE: KATHRYN ANIELA SOCHA MA, BCBA

MEDICARE: KATHRYN ANIELA SOCHA MA, BCBA
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
1101YM0800XMental Health Counselor
2103K00000XBehavior Analyst1-19-38983CA

General Provider Information

NPI Number : 1588114219
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN ANIELA SOCHA MA, BCBA
Provider Business Mailing Address
First Line : 3152 VISTA GRANDE
Second Line :
City : SANTA ROSA VALLEY
State : CA
Zip : 93012-8888
Country : US
Telephone Number : 408-781-2715
Fax Number :
Provider Business Practice Location Address
First Line : 400 W VENTURA BLVD STE 230
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-9142
Country : US
Telephone Number : 858-264-5858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2016
Last Update Date : 12/30/2019

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