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General NPI Number Information
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NPI Number | 1407751449
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Entity Type | Individual
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Provider Name | KATIE VINCENE HARRIS I
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Gender | Female
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 4740 GREEN RIVER RD STE 204
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City | CORONA
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State | CA
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Zip | 92878-9434
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Country | US
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Telephone | 888-515-1793
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Fax | 502-297-0289
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Provider Business Mailing Address
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Address Line | 44684 STATE HIGHWAY 74 APT 1
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City | HEMET
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State | CA
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Zip | 92544-5922
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Country | US
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Telephone | 562-665-0679
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | CA
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