Healthcare Provider Details

I. General information

NPI: 1073981320
Provider Name (Legal Business Name): SEBASTIAN KATTEN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SAMARA KATTEN

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 05/10/2025
Certification Date: 05/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1429 N AVENUE 57
LOS ANGELES CA
90042-1927
US

IV. Provider business mailing address

3941 SANTA CARLOTTA ST
LA CRESCENTA CA
91214-1053
US

V. Phone/Fax

Practice location:
  • Phone: 818-233-0676
  • Fax:
Mailing address:
  • Phone: 818-233-0676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number72158
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number99750
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: