Provider Demographics
NPI:1699300467
Name:NAVARRA, KATHRYN (LMFT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:NAVARRA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:NAVARRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:520 PLAZA DR STE 130
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-4792
Mailing Address - Country:US
Mailing Address - Phone:530-683-2191
Mailing Address - Fax:
Practice Address - Street 1:520 PLAZA DR STE 130
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4792
Practice Address - Country:US
Practice Address - Phone:530-683-2191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA117015106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist