Provider Demographics
NPI:1114284197
Name:KATIE JOSEPHSON INC.
Entity type:Organization
Organization Name:KATIE JOSEPHSON INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPHSON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:805-628-2205
Mailing Address - Street 1:1445 DONLON ST
Mailing Address - Street 2:UNIT 15
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5639
Mailing Address - Country:US
Mailing Address - Phone:805-628-2205
Mailing Address - Fax:805-765-9555
Practice Address - Street 1:209 N ANN ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-2112
Practice Address - Country:US
Practice Address - Phone:805-628-2205
Practice Address - Fax:805-765-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14449171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty