Healthcare Provider Details

I. General information

NPI: 1407588254
Provider Name (Legal Business Name): DESIREE KATRONES LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33339B GLOBE DR
SPRINGVILLE CA
93265-9716
US

IV. Provider business mailing address

33339B GLOBE DR
SPRINGVILLE CA
93265-9716
US

V. Phone/Fax

Practice location:
  • Phone: 559-745-5572
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number117792
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: