Kathy K Butler, PSYCH TECH

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PT36701 Issued in CA

Practice address

19805 Shake Ridge Rd
Volcano, CA 95689-9719

Phone

(805) 769-0301

NPI assigned

Mar 20, 2025

Last updated

Mar 20, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kathy Butler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1742428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1649071283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19805 SHAKE RIDGE RD",
            "city": "VOLCANO",
            "state": "CA",
            "postal_code": "956899719",
            "telephone_number": "805-769-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19805 SHAKE RIDGE RD",
            "city": "VOLCANO",
            "state": "CA",
            "postal_code": "956899719",
            "telephone_number": "805-769-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "KATHY",
        "middle_name": "K",
        "credential": "PSYCH TECH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-20",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT36701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "BUTLER",
            "credential": "WELLS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kim Kathleen Aguayo, D.C.
• Nathaniel Garrett Bland, EMT-I
• Melissa Granchi, MA
• Melissa Granchi
• Holly Lynn Rockett, MBA, MFT

• Licensed Psychiatric Technician in Volcano, CA
• Providers in Volcano, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.