Provider Demographics
NPI:1407639826
Name:FOX, CATHERINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 S MANCHESTER AVE UNIT 3056
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3256
Mailing Address - Country:US
Mailing Address - Phone:970-946-7148
Mailing Address - Fax:
Practice Address - Street 1:385 S MANCHESTER AVE UNIT 3056
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3256
Practice Address - Country:US
Practice Address - Phone:970-946-7148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT144.0134267235Z00000X
CA35393235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist