Provider Demographics
NPI:1720214711
Name:KATEN, KATRINA LYNN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:LYNN
Last Name:KATEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KATRINA
Other - Middle Name:
Other - Last Name:RAYBUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, PSYD
Mailing Address - Street 1:327 N 7TH ST STE 21
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-3402
Mailing Address - Country:US
Mailing Address - Phone:970-628-5589
Mailing Address - Fax:
Practice Address - Street 1:327 N 7TH ST STE 21
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3402
Practice Address - Country:US
Practice Address - Phone:970-628-5589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3377103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical