Provider Demographics
NPI:1699799437
Name:SMITH, CATHERINE S (PHD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:S
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 HOPE ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-2628
Mailing Address - Country:US
Mailing Address - Phone:626-403-8075
Mailing Address - Fax:626-398-1228
Practice Address - Street 1:1605 HOPE ST
Practice Address - Street 2:SUITE 305
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-2628
Practice Address - Country:US
Practice Address - Phone:626-403-8075
Practice Address - Fax:626-398-1228
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8355103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP8335AMedicare ID - Type Unspecified