Provider Demographics
NPI:1336689017
Name:NIERE, KATRINA GARCIA (LMFT)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:GARCIA
Last Name:NIERE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:DBA
Other - Middle Name:
Other - Last Name:MIND HEALTH THERAPY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:43537 RIDGE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-3613
Mailing Address - Country:US
Mailing Address - Phone:909-362-7719
Mailing Address - Fax:
Practice Address - Street 1:43537 RIDGE PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3613
Practice Address - Country:US
Practice Address - Phone:909-362-7719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-01
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105652106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA105652OtherBOARD OF BEHAVIORAL SCIENCES