Healthcare Provider Details

I. General information

NPI: 1336507227
Provider Name (Legal Business Name): KATHLEEN HOUSTON MA, LMFT, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATIE HOUSTON MA, LMFT, BCBA

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 GREEN VALLEY RD
PLACERVILLE CA
95667-8984
US

IV. Provider business mailing address

2723 SANTA CLARA WAY
SACRAMENTO CA
95817-3043
US

V. Phone/Fax

Practice location:
  • Phone: 530-295-2284
  • Fax:
Mailing address:
  • Phone: 916-260-6711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number106454
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-33055
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: