Provider Demographics
NPI:1144403874
Name:HYNES, CATHERINE M (MA, MS, LMFT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:HYNES
Suffix:
Gender:F
Credentials:MA, MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:869 N EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3973
Mailing Address - Country:US
Mailing Address - Phone:909-985-0513
Mailing Address - Fax:
Practice Address - Street 1:869 N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3973
Practice Address - Country:US
Practice Address - Phone:909-985-0513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPUPIL PERSONNEL CRED101YS0200X
CA45113106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool