Individual
KATHLEEN THERESE AGUSTIN MACABITAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 W STEWART DR STE 301, ORANGE, CA 92868-3838
(714) 712-0711
Mailing address
PO BOX 2182, NORWALK, CA 90651-2182
(562) 281-5822
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95025614
CA
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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