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General NPI Number Information
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NPI Number | 1477369676
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Entity Type | Organization
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Legal Business Name | KATERI MENTAL HEALTH, A LICENSED CLINICAL SOCIAL WORKER, INC.
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 2372 MORSE AVE # 968
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City | IRVINE
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State | CA
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Zip | 92614-6234
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Country | US
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Telephone | 213-260-0647
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Fax |
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Provider Business Mailing Address
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Address Line | 2372 MORSE AVE # 968
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City | IRVINE
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State | CA
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Zip | 92614-6234
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Country | US
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Telephone | 213-260-0647
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TAIDE VANESSA MIER-VERA
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Credential | DSW, LCSW, PPSC
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Telephone | 213-260-0647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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