Healthcare Provider Details

I. General information

NPI: 1346164977
Provider Name (Legal Business Name): KATHERINE JEANNE OWEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 N GILBERT RD STE 152
GILBERT AZ
85234-3395
US

IV. Provider business mailing address

40132 VILLAGE RD APT 1713
TEMECULA CA
92591-3534
US

V. Phone/Fax

Practice location:
  • Phone: 951-428-1937
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLP17775
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: