Provider Demographics
NPI:1447556063
Name:ROSS, KATERI MARIE (LMFT #100368)
Entity Type:Individual
Prefix:
First Name:KATERI
Middle Name:MARIE
Last Name:ROSS
Suffix:
Gender:F
Credentials:LMFT #100368
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11880 MARSYAS WAY
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-8057
Mailing Address - Country:US
Mailing Address - Phone:916-224-2517
Mailing Address - Fax:
Practice Address - Street 1:11880 MARSYAS WAY
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-8057
Practice Address - Country:US
Practice Address - Phone:916-224-2517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-28
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100368106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist