Healthcare Provider Details

I. General information

NPI: 1467693218
Provider Name (Legal Business Name): CATHIE FAYE GUM PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2009
Last Update Date: 02/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9171 WILSHIRE BLVD STE 670
BEVERLY HILLS CA
90210-5530
US

IV. Provider business mailing address

9171 WILSHIRE BLVD STE 670
BEVERLY HILLS CA
90210-5530
US

V. Phone/Fax

Practice location:
  • Phone: 310-922-1698
  • Fax: 310-872-5500
Mailing address:
  • Phone: 310-922-1698
  • Fax: 310-872-5500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 22467
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: