Healthcare Provider Details

I. General information

NPI: 1275407181
Provider Name (Legal Business Name): KATHARINE SCHAEFER TREVINO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAY TREVINO

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 N EL MOLINO AVE
PASADENA CA
91101-1805
US

IV. Provider business mailing address

304 N MONTEREY ST APT C
ALHAMBRA CA
91801-2515
US

V. Phone/Fax

Practice location:
  • Phone: 626-792-2770
  • Fax:
Mailing address:
  • Phone: 312-868-2304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: