Provider Demographics
NPI:1619088929
Name:BOSWELL, CATRENA Y (QMHP)
Entity Type:Individual
Prefix:MS
First Name:CATRENA
Middle Name:Y
Last Name:BOSWELL
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5253 MONROE AVE
Mailing Address - Street 2:#1
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-4705
Mailing Address - Country:US
Mailing Address - Phone:619-287-3810
Mailing Address - Fax:
Practice Address - Street 1:2221 CAMINO DEL RIO S
Practice Address - Street 2:305
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3608
Practice Address - Country:US
Practice Address - Phone:619-297-8111
Practice Address - Fax:619-220-0437
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health