Provider Demographics
NPI:1285032524
Name:JOHNSTON, KATHERINE VICTORIA
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:VICTORIA
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KATHERINE
Other - Middle Name:VICTORIA
Other - Last Name:BASSETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:251 N OAKLAND AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101
Mailing Address - Country:US
Mailing Address - Phone:352-871-3398
Mailing Address - Fax:
Practice Address - Street 1:251 N OAKLAND AVE APT 2
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1668
Practice Address - Country:US
Practice Address - Phone:352-871-3398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist