Provider Demographics
NPI:1134524598
Name:HERRERA, KATHRYN CHRISTINE (LPCC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:CHRISTINE
Last Name:HERRERA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 ORANGE AVE # 317
Mailing Address - Street 2:
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-2609
Mailing Address - Country:US
Mailing Address - Phone:760-835-5563
Mailing Address - Fax:877-431-9750
Practice Address - Street 1:333 W HARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-7709
Practice Address - Country:US
Practice Address - Phone:760-835-5563
Practice Address - Fax:877-431-9750
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC1100101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor