Healthcare Provider Details

I. General information

NPI: 1811180771
Provider Name (Legal Business Name): KATHRINE BEJANYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 08/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 GLENDALE LN STE 100
SACRAMENTO CA
95825-2457
US

IV. Provider business mailing address

2330 GLENDALE LN STE 100
SACRAMENTO CA
95825-2457
US

V. Phone/Fax

Practice location:
  • Phone: 916-641-9595
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: