Provider Demographics
NPI:1316514748
Name:CHI, KATHERINE (LCSW122142, PPSC)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:CHI
Suffix:
Gender:F
Credentials:LCSW122142, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1011
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94064-1011
Mailing Address - Country:US
Mailing Address - Phone:650-420-7761
Mailing Address - Fax:650-839-7841
Practice Address - Street 1:647 VETERANS BLVD STE A
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1441
Practice Address - Country:US
Practice Address - Phone:650-420-7761
Practice Address - Fax:650-839-7841
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 1041S0200X
CALCSW1221421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool