Provider Demographics
NPI:1699008573
Name:CONNORS, CATHY (PSYD)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:CONNORS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:
Other - Last Name:SHANNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2360 E BIDWELL ST STE 107
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3406
Mailing Address - Country:US
Mailing Address - Phone:916-671-0678
Mailing Address - Fax:
Practice Address - Street 1:2360 E BIDWELL ST STE 107
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3406
Practice Address - Country:US
Practice Address - Phone:916-671-0678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16017103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist