Provider Demographics
NPI:1023033875
Name:NEUHAUSER, CATHY G (PHD)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:G
Last Name:NEUHAUSER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-4553
Mailing Address - Country:US
Mailing Address - Phone:530-759-0116
Mailing Address - Fax:530-297-0766
Practice Address - Street 1:604 3RD ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4553
Practice Address - Country:US
Practice Address - Phone:530-759-0116
Practice Address - Fax:530-297-0766
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8049103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0555-04OtherPACIFICARE
CA00PL80491Medicare ID - Type Unspecified