Provider Demographics
NPI:1417280686
Name:LOUIE, S. CATHY (PHD)
Entity Type:Individual
Prefix:DR
First Name:S.
Middle Name:CATHY
Last Name:LOUIE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CATHY
Other - Middle Name:
Other - Last Name:LOUIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:150 PAULARINO AVE
Mailing Address - Street 2:STE. C100
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-3301
Mailing Address - Country:US
Mailing Address - Phone:714-913-3431
Mailing Address - Fax:714-549-6711
Practice Address - Street 1:150 PAULARINO AVE
Practice Address - Street 2:SUITE C-100
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-3301
Practice Address - Country:US
Practice Address - Phone:714-913-3431
Practice Address - Fax:714-549-6711
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-04
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18307103T00000X, 103TB0200X, 103TC0700X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2220210OtherCOMPSYCH
12073669OtherCAQH