Provider Demographics
NPI:1356679401
Name:KATZ, JUDITH H (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:H
Last Name:KATZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1738 UNION STREET
Mailing Address - Street 2:#300
Mailing Address - City:SAN-FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4425
Mailing Address - Country:US
Mailing Address - Phone:415-860-4888
Mailing Address - Fax:415-956-0636
Practice Address - Street 1:1738 UNION STREET
Practice Address - Street 2:#300
Practice Address - City:SAN-FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4425
Practice Address - Country:US
Practice Address - Phone:415-860-4888
Practice Address - Fax:415-956-0636
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12660103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
#184972OtherMHN