Provider Demographics
NPI:1053923326
Name:VALENTINE, KATHERINE (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 N SAN FERNANDO BLVD # 268
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-4236
Mailing Address - Country:US
Mailing Address - Phone:818-538-8308
Mailing Address - Fax:
Practice Address - Street 1:1951 N BEACHWOOD DR APT 102
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-4075
Practice Address - Country:US
Practice Address - Phone:818-538-8308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA131427106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty