Healthcare Provider Details

I. General information

NPI: 1487093985
Provider Name (Legal Business Name): EARL J. KATIGBAK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2683 34TH ST APT 9
SANTA MONICA CA
90405-3136
US

IV. Provider business mailing address

2683 34TH ST APT 9
SANTA MONICA CA
90405-3136
US

V. Phone/Fax

Practice location:
  • Phone: 909-203-9773
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: