Healthcare Provider Details

I. General information

NPI: 1912186149
Provider Name (Legal Business Name): CATHERINE A JAFFE PMH. CNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CATHERINE JAFFE 58 MEDFORD ST
ARLINGTON MA
02474
US

IV. Provider business mailing address

CATHERINE JAFFE 58 MEDFORD STREET
ARLINGTON MA
02474
US

V. Phone/Fax

Practice location:
  • Phone: 857-756-3694
  • Fax: 617-475-5019
Mailing address:
  • Phone: 857-756-3694
  • Fax: 617-475-5019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number183994
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: