Healthcare Provider Details

I. General information

NPI: 1598232605
Provider Name (Legal Business Name): KATHRYN MARY PESCH PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2018
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 MARSH AVE STE 100
RENO NV
89509-1652
US

IV. Provider business mailing address

1340 NIXON AVE
RENO NV
89509-2640
US

V. Phone/Fax

Practice location:
  • Phone: 608-628-9758
  • Fax:
Mailing address:
  • Phone: 608-628-9758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY1192
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: