Provider Demographics
NPI:1902115496
Name:REXROAT, KATHERINE MARTINEZ (LMFT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARTINEZ
Last Name:REXROAT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MARIE
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:999 E RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2142
Mailing Address - Country:US
Mailing Address - Phone:559-449-1892
Mailing Address - Fax:
Practice Address - Street 1:1925 E DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-4821
Practice Address - Country:US
Practice Address - Phone:559-600-4645
Practice Address - Fax:559-455-4633
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48998106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist