Provider Demographics
NPI:1083904445
Name:CHEVALIER, KATHERINE JEANETTE (MA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JEANETTE
Last Name:CHEVALIER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:JEANETTE
Other - Last Name:CHEVALIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5 ENCINAL
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610
Mailing Address - Country:US
Mailing Address - Phone:949-939-8885
Mailing Address - Fax:
Practice Address - Street 1:5 ENCINAL
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-1860
Practice Address - Country:US
Practice Address - Phone:949-939-8885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60098106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist