Provider Demographics
NPI:1407018716
Name:CATHERN, ALPHONSO DEVON JR
Entity Type:Individual
Prefix:
First Name:ALPHONSO
Middle Name:DEVON
Last Name:CATHERN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 N OAKLAND AVE
Mailing Address - Street 2:APT #301
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:650 N OAKLAND AVE
Practice Address - Street 2:APT 301
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1155
Practice Address - Country:US
Practice Address - Phone:626-324-7126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor