Healthcare Provider Details
I. General information
NPI: 1346077450
Provider Name (Legal Business Name): C.A.A.T. PSYCHOLOGICAL SERVICES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2024
Last Update Date: 09/14/2024
Certification Date: 09/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21065 VIA TOLEDO
YORBA LINDA CA
92887-2455
US
IV. Provider business mailing address
21065 VIA TOLEDO
YORBA LINDA CA
92887-2455
US
V. Phone/Fax
- Phone: 714-357-7810
- Fax:
- Phone: 714-357-7810
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TIFFANY
SHADER
Title or Position: PRESIDENT
Credential: PHD
Phone: 657-234-2206