Healthcare Provider Details
I. General information
NPI: 1871743880
Provider Name (Legal Business Name): CATHERINE GELA HARRIS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/25/2008
Last Update Date: 07/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12220 FOOTHILL BLVD
SYLMAR CA
91342
US
IV. Provider business mailing address
7775 N PALM AVE., SUITE 102-58
FRESNO CA
93711
US
V. Phone/Fax
- Phone: 818-834-5082
- Fax:
- Phone: 310-809-6644
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PSY22197 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0200X |
| Taxonomy | Forensic Psychologist |
| License Number | PSY22197 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: