Provider Demographics
NPI:1093467326
Name:RALPH, KATHERINE (ACSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:RALPH
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24509 WALNUT ST STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2846
Mailing Address - Country:US
Mailing Address - Phone:940-594-3648
Mailing Address - Fax:
Practice Address - Street 1:24509 WALNUT ST STE 201
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2846
Practice Address - Country:US
Practice Address - Phone:940-594-3648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1049821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical