MEDICARE: MIYA CATO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	84322	CA
2	104100000X	Social Worker	84322	CA
3	104100000X	Social Worker	ASW125087	CA

General Provider Information

NPI Number	:	1467824771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIYA CATO

Provider Business Mailing Address
First Line	:	1216 W AVENUE J STE 300
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-2944
Country	:	US
Telephone Number	:	510-600-4759
Fax Number	:

Provider Business Practice Location Address
First Line	:	1216 W AVENUE J STE 300
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-2944
Country	:	US
Telephone Number	:	510-600-4759
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2015
Last Update Date	:	08/14/2024

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Directions to “ MIYA CATO ” Practice Location

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