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General NPI Number Information
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NPI Number | 1871370643
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Entity Type | Individual
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Provider Name | LATIANA MARSHAYA KATES AMFT
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Gender | Female
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 9412 BIG HORN BLVD STE 6
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City | ELK GROVE
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State | CA
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Zip | 95758-1101
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Country | US
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Telephone | 916-272-5028
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 181
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City | VACAVILLE
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State | CA
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Zip | 95696-0181
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Country | US
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Telephone | 707-384-4347
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT137570
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMF137570
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License Number State | CA
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