=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841615242
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATY HOSLAR LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2014
-----------------------------------------------------
Last Update Date | 10/07/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3088 PIO PICO DRIVE SUITE 203
-----------------------------------------------------
City | CARLSBAD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92008-1965
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-220-9519
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1463 GOLDEN SUNSET DR
-----------------------------------------------------
City | SAN MARCOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92078-4242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-220-9519
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 93168
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------