Provider Demographics
NPI:1083089494
Name:ATHENS, CATHERINE CONSTANCE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:CONSTANCE
Last Name:ATHENS
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 1:303 FIRST ST
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022
Mailing Address - Country:US
Mailing Address - Phone:650-948-1796
Mailing Address - Fax:650-948-6401
Practice Address - Street 1:303 FIRST ST
Practice Address - Street 2:
Practice Address - City:LOS ALTO
Practice Address - State:CA
Practice Address - Zip Code:94022
Practice Address - Country:US
Practice Address - Phone:650-948-1796
Practice Address - Fax:650-948-6401
Is Sole Proprietor?:No
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TF0200X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic