Provider Demographics
NPI:1881733582
Name:VILCHEZ, KATHERINE ANNA (LMFT)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ANNA
Last Name:VILCHEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1743 BREA BLVD
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3918
Mailing Address - Country:US
Mailing Address - Phone:909-902-9111
Mailing Address - Fax:
Practice Address - Street 1:1490 N CLAREMONT BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3519
Practice Address - Country:US
Practice Address - Phone:714-746-6047
Practice Address - Fax:909-833-7195
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39770106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist