Provider Demographics
NPI:1942392345
Name:KATZENSTEIN, GRACE EDITH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:EDITH
Last Name:KATZENSTEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26571 LUCINDA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5925
Mailing Address - Country:US
Mailing Address - Phone:949-348-0534
Mailing Address - Fax:
Practice Address - Street 1:1504 BROOKHOLLOW DR
Practice Address - Street 2:SUITE 117
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5418
Practice Address - Country:US
Practice Address - Phone:714-432-8584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS12411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health