Provider Demographics
NPI:1235260092
Name:PENUELA-PARKER, CATHERINE MICHELLE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:MICHELLE
Last Name:PENUELA-PARKER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:CATHERINE
Other - Middle Name:MICHELLE
Other - Last Name:PENUELAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:26632 ISABELLA PKWY
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351-6917
Mailing Address - Country:US
Mailing Address - Phone:661-645-0914
Mailing Address - Fax:
Practice Address - Street 1:11565 LAUREL CANYON BLVD
Practice Address - Street 2:#114
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4168
Practice Address - Country:US
Practice Address - Phone:818-361-5030
Practice Address - Fax:818-365-7707
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43844106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist