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General NPI Number Information
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NPI Number | 1164616751
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Entity Type | Individual
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Provider Name | CATHERINE ELYSE GREEN M.A.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 5016 PARKWAY CALABASAS
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City | CALABASAS
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State | CA
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Zip | 91302-1419
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Country | US
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Telephone | 818-591-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 5016 PARKWAY CALABASAS
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City | CALABASAS
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State | CA
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Zip | 91302
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Country | US
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Telephone | 818-591-3000
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PSB 33069
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License Number State | CA
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