Healthcare Provider Details

I. General information

NPI: 1881910123
Provider Name (Legal Business Name): CATHERYN VATUONE MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2010
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

469 PINE ST
GRASS VALLEY CA
95945-7350
US

IV. Provider business mailing address

10257 OLD OAK TRL
GRASS VALLEY CA
95945-4577
US

V. Phone/Fax

Practice location:
  • Phone: 530-265-7767
  • Fax: 530-273-6288
Mailing address:
  • Phone: 530-265-7767
  • Fax: 530-273-6288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number27635
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: