Provider Demographics
NPI:1639694391
Name:SCIMIA, KATY REBECCA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KATY
Middle Name:REBECCA
Last Name:SCIMIA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 CARMEL DR.
Mailing Address - Street 2:#205
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4277
Mailing Address - Country:US
Mailing Address - Phone:925-403-1606
Mailing Address - Fax:925-553-5090
Practice Address - Street 1:3075 CITRUS CIRCLE
Practice Address - Street 2:#165
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2669
Practice Address - Country:US
Practice Address - Phone:925-403-1606
Practice Address - Fax:925-553-5090
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-03
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT133101106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist