Provider Demographics
NPI:1992356984
Name:FABRO, KATHARINE (PSYD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:FABRO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:
Other - Last Name:HULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1801 E KATELLA AVE APT 3114
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-6661
Mailing Address - Country:US
Mailing Address - Phone:408-931-1065
Mailing Address - Fax:
Practice Address - Street 1:1801 E KATELLA AVE APT 3114
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-6661
Practice Address - Country:US
Practice Address - Phone:408-931-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-22
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X, 390200000X
CAPSY34208103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program