Provider Demographics
NPI:1669523304
Name:MOESSNER, KATHLINE BERNICE
Entity type:Individual
Prefix:MS
First Name:KATHLINE
Middle Name:BERNICE
Last Name:MOESSNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21501 GOLDEN HILLS BLVD
Mailing Address - Street 2:#A
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-8941
Mailing Address - Country:US
Mailing Address - Phone:661-823-9581
Mailing Address - Fax:
Practice Address - Street 1:8101 BAY AVE
Practice Address - Street 2:
Practice Address - City:CALIFORNIA CITY
Practice Address - State:CA
Practice Address - Zip Code:93505-2695
Practice Address - Country:US
Practice Address - Phone:760-373-2979
Practice Address - Fax:760-373-2980
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor