Provider Demographics
NPI:1932809621
Name:MOTZENBACKER, KATHERINE FRANCES (ACSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:FRANCES
Last Name:MOTZENBACKER
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:THEO
Other - Middle Name:
Other - Last Name:MOTZENBACKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12558 1/2 OXNARD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-4435
Mailing Address - Country:US
Mailing Address - Phone:323-428-5949
Mailing Address - Fax:
Practice Address - Street 1:611 S KINGSLEY DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-2319
Practice Address - Country:US
Practice Address - Phone:213-201-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW113089104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker