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General NPI Number Information
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NPI Number | 1205655065
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Entity Type | Individual
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Provider Name | KATHERINE JANE ALLEN
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Gender | Female
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 31630 RAILROAD CANYON RD STE 2
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City | CANYON LAKE
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State | CA
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Zip | 92587-9478
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Country | US
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Telephone | 760-283-6817
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Fax |
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Provider Business Mailing Address
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Address Line | 27890 CLINTON KEITH RD STE D122
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City | MURRIETA
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State | CA
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Zip | 92562-8571
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 17524
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License Number State | CA
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