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General NPI Number Information
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NPI Number | 1265459911
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Entity Type | Organization
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Legal Business Name | KATHERINE Y. KO, PH.D. & ASSOCIATES, A PSYCHOLOGICAL ASSOCIATION
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4000 BARRANCA PKWY STE 250
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City | IRVINE
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State | CA
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Zip | 92604-1713
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Country | US
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Telephone | 949-262-3696
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 BARRANCA PKWY STE 250
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City | IRVINE
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State | CA
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Zip | 92604-1713
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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 | PRESIDENT
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Name | DR. KATHERINE KO
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Credential | PH.D.
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Telephone | 949-262-3696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY18545
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License Number State | CA
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