Doctor Name: | MRS. KATHY ANGELA WATSON |
NPI Number: | 1114362605 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 2046 Allen Ave Altadena, CA - 910013424 |
Business Phone Number: | 6263965920 |
Business Fax Number: | |
Mailing Address: | 2046 Allen Ave, ALTADENA |
State: | CA |
Postal Code: | 910013424 |
Phone Number: | 6263965920 |
Fax Number: | |
NPI Enumeration Date: | 05/09/2013 |
NPI Last Update Date: | 05/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |