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General NPI Number Information
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NPI Number | 1144865593
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Entity Type | Individual
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Provider Name | CATHERINE ANN GERCICH
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Gender | Female
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Dates
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Enumeration Date | 11/08/2019
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Last Update Date | 10/18/2021
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Provider Practice Location Address
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Address Line | 20342 FLANAGAN ROAD
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City | TRABUCO CANYON
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State | CA
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Zip | 92679
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Country | US
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Telephone | 818-582-8832
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Fax | 818-582-8836
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Provider Business Mailing Address
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Address Line | 705 AVENIDA SEVILLA UNIT C
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-8038
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Country | US
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Telephone | 949-307-1904
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374700000X
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Taxonomy Name | Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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