Provider Demographics
NPI:1568015626
Name:BUCHAN, KATHRYN TAYLOR PORTER (LPCC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:TAYLOR PORTER
Last Name:BUCHAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 EASY LN
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:CA
Mailing Address - Zip Code:95713-9645
Mailing Address - Country:US
Mailing Address - Phone:805-801-2724
Mailing Address - Fax:
Practice Address - Street 1:5980 WEBB ST
Practice Address - Street 2:
Practice Address - City:LOOMIS
Practice Address - State:CA
Practice Address - Zip Code:95650-7625
Practice Address - Country:US
Practice Address - Phone:916-652-0171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC2371101YS0200X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool