Provider Demographics
NPI:1164096061
Name:KATRACK, NASHA (LCSW)
Entity Type:Individual
Prefix:
First Name:NASHA
Middle Name:
Last Name:KATRACK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91365-0002
Mailing Address - Country:US
Mailing Address - Phone:661-644-9245
Mailing Address - Fax:
Practice Address - Street 1:23734 VALENCIA BLVD STE 304
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5369
Practice Address - Country:US
Practice Address - Phone:234-281-2154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-14
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1014881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical