Provider Demographics
NPI:1417935081
Name:FRENETTE, CATHERINE THERESE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:THERESE
Last Name:FRENETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:THERESE
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10666 N TORREY PINES RD
Mailing Address - Street 2:N200
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1027
Mailing Address - Country:US
Mailing Address - Phone:858-554-4310
Mailing Address - Fax:858-554-3009
Practice Address - Street 1:10666 N TORREY PINES RD
Practice Address - Street 2:N200
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1027
Practice Address - Country:US
Practice Address - Phone:858-554-4310
Practice Address - Fax:858-554-3009
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80461207RG0100X, 207RI0008X
TXN8294207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280753901Medicaid
TX1417935081OtherBLUE CROSS BLUE SHIELD
TXP01030946OtherRR MEDICARE
TX280753902Medicaid
CA00A804610Medicaid
LA2315021Medicaid
TX1417935081OtherBLUE CROSS BLUE SHIELD
TX280753901Medicaid
CA00A804610Medicaid
CAWA80461AMedicare ID - Type UnspecifiedGROUP#W7168