Healthcare Provider Details

I. General information

NPI: 1124451117
Provider Name (Legal Business Name): KATHRYN HREN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATIE HREN LCSW

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 3/4 SILVER LAKE BLVD APT 3
LOS ANGELES CA
90026-1359
US

IV. Provider business mailing address

1616 3/4 SILVER LAKE BLVD APT 3
LOS ANGELES CA
90026-1359
US

V. Phone/Fax

Practice location:
  • Phone: 323-813-5260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number76175
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: