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General NPI Number Information
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NPI Number | 1437766847
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Entity Type | Individual
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Provider Name | KATHERYN ROSE HAYWARD
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Gender | Female
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Dates
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Enumeration Date | 09/29/2020
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 14500 ROSCOE BLVD STE 400
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4194
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Country | US
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Telephone | 760-899-8447
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 90392
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City | PASADENA
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State | CA
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Zip | 91109-0392
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Country | US
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Telephone | 760-899-8447
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW107167
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License Number State | CA
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