Healthcare Provider Details

I. General information

NPI: 1508107467
Provider Name (Legal Business Name): CATHERINE BERNARDING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 03/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2253 E DUDLEY ST
PASADENA CA
91104-4126
US

IV. Provider business mailing address

2253 DUDLEY STREET
PASADENA CA
91104
US

V. Phone/Fax

Practice location:
  • Phone: 626-797-7681
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS8936
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: