Provider Demographics
NPI:1023541778
Name:OPKINS, KATHERINE (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:OPKINS
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1055 E COLORADO BLVD STE 560
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2380
Mailing Address - Country:US
Mailing Address - Phone:818-241-6780
Mailing Address - Fax:818-241-6853
Practice Address - Street 1:5312 BOLSA AVE STE 105
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-1060
Practice Address - Country:US
Practice Address - Phone:714-965-2324
Practice Address - Fax:818-241-6853
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27006235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty