Provider Demographics
NPI:1063793321
Name:YBARRA, CATHERINE (MSW)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:YBARRA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 W EL SEGUNDO BLVD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-3317
Mailing Address - Country:US
Mailing Address - Phone:323-754-2816
Mailing Address - Fax:323-754-2828
Practice Address - Street 1:2501 W. EL SEGUNDO BLVD.
Practice Address - Street 2:
Practice Address - City:HAWTHRONE
Practice Address - State:CA
Practice Address - Zip Code:90250
Practice Address - Country:US
Practice Address - Phone:323-754-2816
Practice Address - Fax:323-754-2828
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10063101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)