Provider Demographics
NPI:1124672514
Name:WEEKS, KATHERINE PENELOPE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:PENELOPE
Last Name:WEEKS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28801 JAEGER DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1325
Mailing Address - Country:US
Mailing Address - Phone:949-395-3321
Mailing Address - Fax:
Practice Address - Street 1:28801 JAEGER DR
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1325
Practice Address - Country:US
Practice Address - Phone:949-295-3321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-24
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011910363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health