Provider Demographics
NPI:1790863231
Name:HERRERA, KATHLEEN YVETTE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:YVETTE
Last Name:HERRERA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 POPE ST
Mailing Address - Street 2:STE. 204
Mailing Address - City:SAINT HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574-1280
Mailing Address - Country:US
Mailing Address - Phone:707-967-0468
Mailing Address - Fax:707-967-1094
Practice Address - Street 1:1127 POPE ST
Practice Address - Street 2:STE. 204
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-1280
Practice Address - Country:US
Practice Address - Phone:707-967-0468
Practice Address - Fax:707-967-1094
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS180091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical