Provider Demographics
NPI:1730819327
Name:LOUKS, KATHERYN ANN (RADT)
Entity type:Individual
Prefix:MISS
First Name:KATHERYN
Middle Name:ANN
Last Name:LOUKS
Suffix:
Gender:F
Credentials:RADT
Other - Prefix:MISS
Other - First Name:KATHERYN
Other - Middle Name:ANN
Other - Last Name:LOUKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RADT
Mailing Address - Street 1:867 GOLDNER CT
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-6450
Mailing Address - Country:US
Mailing Address - Phone:530-317-9512
Mailing Address - Fax:
Practice Address - Street 1:484 PLESANT VALLEY RD
Practice Address - Street 2:SUITE#4
Practice Address - City:DIAMOND SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95619-9566
Practice Address - Country:US
Practice Address - Phone:530-344-7633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1460090322101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)