Provider Demographics
NPI:1013070218
Name:CATOMERISIOS, VICKI LORRAINE (MFTI)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:LORRAINE
Last Name:CATOMERISIOS
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 COHASSET RD STE 15
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2260
Mailing Address - Country:US
Mailing Address - Phone:530-891-2839
Mailing Address - Fax:
Practice Address - Street 1:500 COHESSET ROAD
Practice Address - Street 2:SUITE 15
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-891-2945
Practice Address - Fax:530-895-6669
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF52042106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist