Provider Demographics
NPI:1356481956
Name:RETO, CATHY SUE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:SUE
Last Name:RETO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4452 PARK BLVD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-4051
Mailing Address - Country:US
Mailing Address - Phone:619-574-7525
Mailing Address - Fax:619-574-6969
Practice Address - Street 1:4452 PARK BLVD
Practice Address - Street 2:SUITE 309
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-4051
Practice Address - Country:US
Practice Address - Phone:619-574-7525
Practice Address - Fax:619-574-6969
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16625103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical