MEDICARE: ELIZABETH KATCHER PHD

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	103TC0700X	Clinical Psychologist	32175	CA

General Provider Information

NPI Number	:	1811588312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH KATCHER PHD

Provider Business Mailing Address
First Line	:	15243 LA CRUZ DR UNIT 1237
Second Line	:
City	:	PACIFIC PALISADES
State	:	CA
Zip	:	90272-5381
Country	:	US
Telephone Number	:	323-813-6265
Fax Number	:

Provider Business Practice Location Address
First Line	:	10850 WILSHIRE BLVD STE 850
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4608
Country	:	US
Telephone Number	:	323-813-6265
Fax Number	:

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

Provider Enumeration Date	:	01/28/2021
Last Update Date	:	01/28/2021

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Directions to “ ELIZABETH KATCHER PHD” Practice Location

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