Provider Demographics
NPI:1629195698
Name:HARTSHORN, CATHERINE B (LCSW 6362)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:B
Last Name:HARTSHORN
Suffix:
Gender:F
Credentials:LCSW 6362
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2747 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1306
Mailing Address - Country:US
Mailing Address - Phone:510-845-0999
Mailing Address - Fax:
Practice Address - Street 1:2747 FOREST AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1306
Practice Address - Country:US
Practice Address - Phone:510-845-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 63621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical