MEDICARE: MS. KATHLEEN-ANN LAXAMANA ATIENZA LMFT

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
1	106H00000X	Marriage & Family Therapist	161292	CA

General Provider Information

NPI Number	:	1710681051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN-ANN LAXAMANA ATIENZA LMFT

Provider Business Mailing Address
First Line	:	PO BOX 33752
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92163-3752
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7670 OPPORTUNITY RD STE 255
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-2272
Country	:	US
Telephone Number	:	619-772-1845
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2023
Last Update Date	:	04/08/2026

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