Provider Demographics
NPI:1124459417
Name:CATHERS, CADYN (PSYD, MA)
Entity type:Individual
Prefix:DR
First Name:CADYN
Middle Name:
Last Name:CATHERS
Suffix:
Gender:M
Credentials:PSYD, MA
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:CATHERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2699 1/2 BEACHWOOD BLVD
Mailing Address - Street 2:#161
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068
Mailing Address - Country:US
Mailing Address - Phone:310-616-6226
Mailing Address - Fax:
Practice Address - Street 1:6700 HILLPARK DR APT 204
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-2111
Practice Address - Country:US
Practice Address - Phone:310-616-6226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32839103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA01261511Medicaid