Provider Demographics
NPI:1700222346
Name:CATALAN, GRACIELA
Entity Type:Individual
Prefix:
First Name:GRACIELA
Middle Name:
Last Name:CATALAN
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 1:3601 PACIFIC AVE
Mailing Address - Street 2:PSYCHOLOGY DEPARTMENT
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95211-0110
Mailing Address - Country:US
Mailing Address - Phone:209-946-2132
Mailing Address - Fax:
Practice Address - Street 1:3601 PACIFIC AVE
Practice Address - Street 2:PSYCHOLOGY DEPARTMENT
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95211-0110
Practice Address - Country:US
Practice Address - Phone:209-946-2132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program