Provider Demographics
NPI:1013101252
Name:PLIMPTON, KATIE ANN (MA)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ANN
Last Name:PLIMPTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ANN
Other - Last Name:PLIMPTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3200 MOTOR AVENUE
Mailing Address - Street 2:VISTA DEL MAR CHILD AND FAMILY SERVICE, J.A.S. CENTER
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-3710
Mailing Address - Country:US
Mailing Address - Phone:310-836-1223
Mailing Address - Fax:
Practice Address - Street 1:3200 MOTOR AVE
Practice Address - Street 2:VISTA DEL MAR, J.A.S. CNT.
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-3710
Practice Address - Country:US
Practice Address - Phone:310-836-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool