Provider Demographics
NPI:1275722050
Name:DOHERTY, CATHERINE SUSANNE
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:SUSANNE
Last Name:DOHERTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:SUSANNE
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 5TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-6591
Mailing Address - Country:US
Mailing Address - Phone:530-753-0220
Mailing Address - Fax:530-753-3390
Practice Address - Street 1:2100 5TH ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-6591
Practice Address - Country:US
Practice Address - Phone:530-753-0220
Practice Address - Fax:530-753-3390
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health