Healthcare Provider Details

I. General information

NPI: 1962606590
Provider Name (Legal Business Name): CATHERINE ELIZABETH LIEB L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 05/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2609 F ST
SACRAMENTO CA
95816-3713
US

IV. Provider business mailing address

2609 F ST
SACRAMENTO CA
95816-3713
US

V. Phone/Fax

Practice location:
  • Phone: 916-705-8961
  • Fax:
Mailing address:
  • Phone: 916-705-8961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCS17509
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: