Provider Demographics
NPI:1336507227
Name:HOUSTON, KATHLEEN (MA, LMFT, BCBA)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:MA, LMFT, BCBA
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:HOUSTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LMFT, BCBA
Mailing Address - Street 1:2723 SANTA CLARA WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-3043
Mailing Address - Country:US
Mailing Address - Phone:916-260-6711
Mailing Address - Fax:
Practice Address - Street 1:6767 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-8984
Practice Address - Country:US
Practice Address - Phone:530-295-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-18-33055103K00000X
CA106454101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst