Provider Demographics
NPI:1962757211
Name:VASQUEZ, KATE TAYLOR (MA LMFT #104833)
Entity type:Individual
Prefix:MS
First Name:KATE
Middle Name:TAYLOR
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:MA LMFT #104833
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 SIERRA CT STE A6
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-7609
Mailing Address - Country:US
Mailing Address - Phone:661-262-9456
Mailing Address - Fax:
Practice Address - Street 1:190 SIERRA CT STE A6
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-7609
Practice Address - Country:US
Practice Address - Phone:661-262-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 95418101YM0800X
CA104833106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist