Provider Demographics
NPI:1245775758
Name:CIANCI, KATHERINE (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:CIANCI
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 1:23845 MCBEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2001
Mailing Address - Country:US
Mailing Address - Phone:661-478-4619
Mailing Address - Fax:
Practice Address - Street 1:27831 SMYTH DR
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-4011
Practice Address - Country:US
Practice Address - Phone:661-478-4619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA749641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical