Provider Demographics
NPI:1225575293
Name:GRAY, CATHERINE LYNN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LYNN
Last Name:GRAY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 131
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91102-0131
Mailing Address - Country:US
Mailing Address - Phone:626-524-2157
Mailing Address - Fax:
Practice Address - Street 1:30 NORTH RAYMOND AVENUE
Practice Address - Street 2:SUITE 403
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103
Practice Address - Country:US
Practice Address - Phone:626-524-2157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27187103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical