MEDICARE: KARI KATZENMEIER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	86045	CA

General Provider Information

NPI Number	:	1245780063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI KATZENMEIER

Provider Business Mailing Address
First Line	:	15829 VIA MONTENERO
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92127-4196
Country	:	US
Telephone Number	:	858-603-8921
Fax Number	:

Provider Business Practice Location Address
First Line	:	1455 FRAZEE RD
Second Line	:	SUITE 500
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4301
Country	:	US
Telephone Number	:	858-603-8921
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2016
Last Update Date	:	10/05/2016

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