Individual
KATHY K BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYCH TECH
Contact information
Practice address
19805 SHAKE RIDGE RD, VOLCANO, CA 95689-9719
(805) 769-0301
Mailing address
19805 SHAKE RIDGE RD, VOLCANO, CA 95689-9719
(805) 769-0301
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT36701
CA
Other
Enumeration date
03/20/2025
Last updated
03/20/2025
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