Healthcare Provider Details

I. General information

NPI: 1801471537
Provider Name (Legal Business Name): CATHERINE ELIZABETH BOYLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2021
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 N 1ST ST STE 124&112
FRESNO CA
93726-6800
US

IV. Provider business mailing address

3636 N 1ST ST STE 124 &112
FRESNO CA
93726-6818
US

V. Phone/Fax

Practice location:
  • Phone: 559-476-2177
  • Fax:
Mailing address:
  • Phone: 559-476-2177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC6537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: