Healthcare Provider Details

I. General information

NPI: 1306782404
Provider Name (Legal Business Name): KATELYN MARIE LUONG-FICENEC C-LD, C-CBE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATELYN MARIE FICENEC

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3216 DARBY ST UNIT 203
SIMI VALLEY CA
93063-2563
US

IV. Provider business mailing address

3216 DARBY ST UNIT 203
SIMI VALLEY CA
93063-2563
US

V. Phone/Fax

Practice location:
  • Phone: 805-298-1248
  • Fax:
Mailing address:
  • Phone: 805-298-1248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: