Provider Demographics
NPI:1114890308
Name:CATANA, JULIAN TIMOTHY
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:TIMOTHY
Last Name:CATANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4283 WISTERIA LN
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-2622
Mailing Address - Country:US
Mailing Address - Phone:208-901-4773
Mailing Address - Fax:
Practice Address - Street 1:4283 WISTERIA LN
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-2622
Practice Address - Country:US
Practice Address - Phone:208-901-4773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-353771041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Single Specialty