Provider Demographics
NPI:1356008221
Name:LANDRUM, CATHERINE (PMHNP B-C)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:LANDRUM
Suffix:
Gender:F
Credentials:PMHNP B-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2659 STATE ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1627
Mailing Address - Country:US
Mailing Address - Phone:855-387-4378
Mailing Address - Fax:760-683-6756
Practice Address - Street 1:1279 MEADOWBROOK AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-2816
Practice Address - Country:US
Practice Address - Phone:310-739-4571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-26
Last Update Date:2025-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019315363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health