Provider Demographics
NPI:1528823002
Name:MONDRAGON, KATHERINE LISA (RN PMHNP)
Entity type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:LISA
Last Name:MONDRAGON
Suffix:
Gender:F
Credentials:RN PMHNP
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Mailing Address - Street 1:4002 WOODBRIAR CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2852
Mailing Address - Country:US
Mailing Address - Phone:832-816-6711
Mailing Address - Fax:
Practice Address - Street 1:7877 WILLOW CHASE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5934
Practice Address - Country:US
Practice Address - Phone:832-869-4818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1152853363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health