Provider Demographics
NPI:1598020026
Name:ESPY-COOK, CATHY MARIE
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:MARIE
Last Name:ESPY-COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10799 POPLAR ST
Mailing Address - Street 2:147
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2254
Mailing Address - Country:US
Mailing Address - Phone:909-799-8599
Mailing Address - Fax:
Practice Address - Street 1:10799 POPLAR ST
Practice Address - Street 2:# 147
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2254
Practice Address - Country:US
Practice Address - Phone:909-799-8599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant