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General NPI Number Information
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NPI Number | 1861577967
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Entity Type | Individual
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Provider Name | CATHERINE V. BENNETT MFT
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 9655 GRANITE RIDGE DR STE 2000027
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City | SAN DIEGO
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State | CA
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Zip | 92123-2674
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Country | US
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Telephone | 619-823-0204
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Fax | 858-459-2128
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Provider Business Mailing Address
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Address Line | 9655 GRANITE RIDGE DR STE 200-0027
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City | SAN DIEGO
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State | CA
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Zip | 92123-2674
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Country | US
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Telephone | 619-823-0204
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Fax | 858-459-2128
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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 | MFT18154
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License Number State | CA
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