Provider Demographics
NPI:1730940586
Name:TROXELL, KATIE (PHD)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:
Last Name:TROXELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:VAN MOORLEGHEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10953 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5519
Mailing Address - Country:US
Mailing Address - Phone:714-914-6576
Mailing Address - Fax:
Practice Address - Street 1:10953 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5519
Practice Address - Country:US
Practice Address - Phone:714-914-6576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY34804103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical