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NPI Code Detail

MEDICARE: MRS. CATHERINE DILLAVOU MSW

MEDICARE:  MRS. CATHERINE  DILLAVOU  MSW
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
1101YM0800XMental Health CounselorASW11142CA

General Provider Information

NPI Number : 1821128729
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CATHERINE DILLAVOU MSW
Provider Business Mailing Address
First Line : 699 CORNELL RD
Second Line :
City : PASADENA
State : CA
Zip : 91106-3817
Country : US
Telephone Number : 323-221-4134
Fax Number : 323-226-4588
Provider Business Practice Location Address
First Line : 1721 GRIFFIN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-3062
Country : US
Telephone Number : 323-221-4134
Fax Number : 323-226-4588
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2007
Last Update Date : 07/08/2007

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