Provider Demographics
NPI:1689026346
Name:GIRARD, CATHERINE JANET (MFT)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:JANET
Last Name:GIRARD
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 W AVENIDA SANTIAGO
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-4227
Mailing Address - Country:US
Mailing Address - Phone:949-226-2719
Mailing Address - Fax:
Practice Address - Street 1:657 CAMINO DE LOS MARES
Practice Address - Street 2:SUITE 241
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-2826
Practice Address - Country:US
Practice Address - Phone:949-226-2719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91148106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist