Provider Demographics
NPI:1790114213
Name:HOSTETTLER, KATHRYN (MSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:HOSTETTLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7113 OAKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3627
Mailing Address - Country:US
Mailing Address - Phone:609-356-8643
Mailing Address - Fax:
Practice Address - Street 1:7113 OAKDALE AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-3627
Practice Address - Country:US
Practice Address - Phone:609-356-8643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL057371001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical