Healthcare Provider Details

I. General information

NPI: 1437632544
Provider Name (Legal Business Name): CATALINA PACHECO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5628 E SLAUSON AVE
COMMERCE CA
90040-2922
US

IV. Provider business mailing address

427 S VANCOUVER AVE
LOS ANGELES CA
90022-1939
US

V. Phone/Fax

Practice location:
  • Phone: 626-773-3761
  • Fax:
Mailing address:
  • Phone: 323-316-4995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number131875
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number108003
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: