Healthcare Provider Details

I. General information

NPI: 1154282812
Provider Name (Legal Business Name): CATHERINE KHAJAVI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE OGDEN

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 MONTIEL RD STE 143
ESCONDIDO CA
92026-2242
US

IV. Provider business mailing address

39660 TINDERBOX WAY
MURRIETA CA
92562-4779
US

V. Phone/Fax

Practice location:
  • Phone: 760-410-4555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number230117411
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: