Healthcare Provider Details

I. General information

NPI: 1194357566
Provider Name (Legal Business Name): KATE HOWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATE BOSCOLO

II. Dates (important events)

Enumeration Date: 02/04/2020
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9920 PACIFIC HEIGHTS BLVD SUITE 150
SAN DIEGO CA
92121-4396
US

IV. Provider business mailing address

2186 SHY BEAR WAY NW APT 204
ISSAQUAH WA
98027-5634
US

V. Phone/Fax

Practice location:
  • Phone: 303-989-8169
  • Fax:
Mailing address:
  • Phone: 661-877-7989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61410151
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: