Healthcare Provider Details
I. General information
NPI: 1144883737
Provider Name (Legal Business Name): KATHERINE CASEY VOLTZ MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/18/2019
Last Update Date: 04/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1529 E PALMDALE BLVD STE 210
PALMDALE CA
93550-2029
US
IV. Provider business mailing address
1529 E PALMDALE BLVD STE 210
PALMDALE CA
93550-2029
US
V. Phone/Fax
- Phone: 661-272-9996
- Fax: 661-272-0438
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | AMFT103165 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: