Healthcare Provider Details
I. General information
NPI: 1346354990
Provider Name (Legal Business Name): CATHERINE SCHUYLER BRENNAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/19/2006
Last Update Date: 03/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1712 PICASSO AVE SUITE D
DAVIS CA
95618-0546
US
IV. Provider business mailing address
3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US
V. Phone/Fax
- Phone: 530-297-7500
- Fax:
- Phone: 916-576-7900
- Fax: 916-285-0338
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | G73257 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | G73257 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: