Provider Demographics
NPI:1144382920
Name:WALTERS, CATHIA T (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CATHIA
Middle Name:T
Last Name:WALTERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:CATHIA
Other - Middle Name:
Other - Last Name:WALTERS-KNIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:2161 SAN PABLO AVE
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-1701
Mailing Address - Country:US
Mailing Address - Phone:510-499-4054
Mailing Address - Fax:
Practice Address - Street 1:2161 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-1701
Practice Address - Country:US
Practice Address - Phone:510-499-4054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20242103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical