Provider Demographics
NPI:1356008221
Name:LANDRUM, CATHERINE (PMHNP B-C)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:LANDRUM
Suffix:
Gender:F
Credentials:PMHNP B-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 WESTWOOD PLZ
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-8358
Mailing Address - Country:US
Mailing Address - Phone:310-267-7365
Mailing Address - Fax:
Practice Address - Street 1:1279 MEADOWBROOK AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-2816
Practice Address - Country:US
Practice Address - Phone:310-739-4571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-26
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA499488163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health