Provider Demographics
NPI:1730475021
Name:GRELLAS, CATHERINE (RN, MFT INTERN)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:GRELLAS
Suffix:
Gender:F
Credentials:RN, MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 934
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-0934
Mailing Address - Country:US
Mailing Address - Phone:650-208-3997
Mailing Address - Fax:
Practice Address - Street 1:36 37TH AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-4405
Practice Address - Country:US
Practice Address - Phone:650-295-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1679619910OtherCATHOLIC CHARITIES CYO