Provider Demographics
NPI:1942556139
Name:WESTENGARD, KATHERINE MARIE (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:MARIE
Last Name:WESTENGARD
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1579 VALLEY FALLS AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2776
Mailing Address - Country:US
Mailing Address - Phone:513-645-3752
Mailing Address - Fax:
Practice Address - Street 1:104 E OLIVE AVE STE 201
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5255
Practice Address - Country:US
Practice Address - Phone:513-645-3752
Practice Address - Fax:951-848-6277
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89040106H00000X
CA64443106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist