Provider Demographics
NPI:1598995011
Name:TRUITT, KATHRYN GRACE (PHD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:GRACE
Last Name:TRUITT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 S RAYMOND AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-1960
Mailing Address - Country:US
Mailing Address - Phone:323-868-3989
Mailing Address - Fax:
Practice Address - Street 1:32 S RAYMOND AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-1960
Practice Address - Country:US
Practice Address - Phone:323-868-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist