Provider Demographics
NPI:1699007724
Name:CHASE, KATHERINE KAYE
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:KAYE
Last Name:CHASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 N O ST
Mailing Address - Street 2:#92
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-4057
Mailing Address - Country:US
Mailing Address - Phone:805-736-0357
Mailing Address - Fax:805-737-0389
Practice Address - Street 1:604 W OCEAN AVE
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-6630
Practice Address - Country:US
Practice Address - Phone:805-736-0357
Practice Address - Fax:805-737-0389
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator