Provider Demographics
NPI:1568915445
Name:STEELE, KATELYN LEILANI (BA)
Entity Type:Individual
Prefix:MS
First Name:KATELYN
Middle Name:LEILANI
Last Name:STEELE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11170 AQUA VISTA ST
Mailing Address - Street 2:B311
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91602-3102
Mailing Address - Country:US
Mailing Address - Phone:808-347-8133
Mailing Address - Fax:
Practice Address - Street 1:11170 AQUA VISTA ST
Practice Address - Street 2:B311
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91602-3102
Practice Address - Country:US
Practice Address - Phone:808-347-8133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0000103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical