Provider Demographics
NPI:1356929756
Name:WASIELEWSKI, KATHLEEN (LCSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:WASIELEWSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:SAENZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1935 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:PENRYN
Mailing Address - State:CA
Mailing Address - Zip Code:95663-9407
Mailing Address - Country:US
Mailing Address - Phone:916-501-2301
Mailing Address - Fax:
Practice Address - Street 1:3175 SUNSET BLVD STE 107
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-3091
Practice Address - Country:US
Practice Address - Phone:916-235-3150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA278101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical