MEDICARE: KATHERINE ELIZABETH BROWN LCSW

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	1041C0700X	Clinical Social Worker	110733	CA

General Provider Information

NPI Number	:	1679059109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE ELIZABETH BROWN LCSW

Provider Business Mailing Address
First Line	:	PO BOX 3244
Second Line	:
City	:	MERCED
State	:	CA
Zip	:	95344-1244
Country	:	US
Telephone Number	:	209-761-0729
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 E SHAW AVE STE 109
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-7903
Country	:	US
Telephone Number	:	559-712-8505
Fax Number	:

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

Provider Enumeration Date	:	07/18/2018
Last Update Date	:	11/15/2022

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