Provider Demographics
NPI:1518900521
Name:GUERNSEY BROWN, KATHRIN VIRGINIA (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHRIN
Middle Name:VIRGINIA
Last Name:GUERNSEY BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GOVERNORS LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-5590
Mailing Address - Country:US
Mailing Address - Phone:530-345-2013
Mailing Address - Fax:530-345-4934
Practice Address - Street 1:6 GOVERNORS LN
Practice Address - Street 2:SUITE A
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-5590
Practice Address - Country:US
Practice Address - Phone:530-345-2013
Practice Address - Fax:530-345-4934
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS130511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS13051OtherSTATE LICENSE