Provider Demographics
NPI:1881123800
Name:ZELJAK, KATRINA MARIE (LMFT99775)
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:MARIE
Last Name:ZELJAK
Suffix:
Gender:F
Credentials:LMFT99775
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6994 EL CAMINO REAL STE 205B
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-4153
Mailing Address - Country:US
Mailing Address - Phone:760-815-2525
Mailing Address - Fax:760-931-9333
Practice Address - Street 1:6994 EL CAMINO REAL STE 205B
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-4153
Practice Address - Country:US
Practice Address - Phone:760-815-2525
Practice Address - Fax:760-931-9333
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT99775106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist