Provider Demographics
NPI:1518627025
Name:ROJO, KATHRYN CAMPBELL (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:CAMPBELL
Last Name:ROJO
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 W ALAMEDA AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4153
Mailing Address - Country:US
Mailing Address - Phone:818-208-0292
Mailing Address - Fax:
Practice Address - Street 1:4100 W ALAMEDA AVE STE 300
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4153
Practice Address - Country:US
Practice Address - Phone:818-208-0292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-23
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA113149106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty