MEDICARE: DR CATHERINE J WARD PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1710656137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR CATHERINE J WARD PSYD

Provider Business Mailing Address
First Line	:	1549 N VULCAN AVE SPC 1
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-1547
Country	:	US
Telephone Number	:	833-988-2115
Fax Number	:	833-997-0837

Provider Business Practice Location Address
First Line	:	2774 JEFFERSON ST
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-1769
Country	:	US
Telephone Number	:	833-933-2115
Fax Number	:	833-997-0837

Authorized Official
Title or Position	:	SECRETARY
Name	:	DR. CATHERINE JUNE WARD
Credential	:	PSYD
Telephone Number	:	833-933-2115

Provider Enumeration Date	:	09/09/2021
Last Update Date	:	09/09/2021

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