Provider Demographics
NPI:1316728710
Name:CATON, ODESSA JADE
Entity type:Individual
Prefix:
First Name:ODESSA
Middle Name:JADE
Last Name:CATON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 AYERS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-3105
Mailing Address - Country:US
Mailing Address - Phone:925-864-0430
Mailing Address - Fax:
Practice Address - Street 1:7677 OAKPORT ST STE 100
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-1939
Practice Address - Country:US
Practice Address - Phone:510-599-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist