Healthcare Provider Details

I. General information

NPI: 1386315018
Provider Name (Legal Business Name): KATRINA ELAINE PAZ LCSCW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

988 MCCOURTNEY RD
GRASS VALLEY CA
95949-7400
US

IV. Provider business mailing address

988 MCCOURTNEY RD
GRASS VALLEY CA
95949-7400
US

V. Phone/Fax

Practice location:
  • Phone: 530-388-8603
  • Fax:
Mailing address:
  • Phone: 530-470-2736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number137698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: