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General NPI Number Information
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NPI Number | 1447967088
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Entity Type | Organization
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Legal Business Name | KATHRYN KROTZ PSYCHOLOGY INC.
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Dates
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Enumeration Date | 11/02/2022
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 242 W MAIN ST STE 200K
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City | TUSTIN
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State | CA
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Zip | 92780-7742
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Country | US
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Telephone | 949-568-3591
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Fax |
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Provider Business Mailing Address
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Address Line | 970 W 190TH ST STE 220
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City | TORRANCE
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State | CA
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Zip | 90502-1090
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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 | CEO
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Name | KATHRYN KROTZ
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Credential | PSYD
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Telephone | 949-568-3591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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