Provider Demographics
NPI:1447549415
Name:MAYEDA, KATHERINE LEE (MSW)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LEE
Last Name:MAYEDA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:KATIE
Other - Middle Name:LEE
Other - Last Name:WILHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:121 BUCKINGHAM DR UNIT 30
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-6549
Mailing Address - Country:US
Mailing Address - Phone:916-230-7465
Mailing Address - Fax:
Practice Address - Street 1:121 BUCKINGHAM DR UNIT 30
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-6549
Practice Address - Country:US
Practice Address - Phone:916-230-7465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical