Provider Demographics
NPI:1134349228
Name:UNDERWOOD, CATHERINE MARIA (MFT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARIA
Last Name:UNDERWOOD
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:PO BOX 138
Mailing Address - Street 2:
Mailing Address - City:COLOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95613-0138
Mailing Address - Country:US
Mailing Address - Phone:530-906-5836
Mailing Address - Fax:
Practice Address - Street 1:550 MAIN ST
Practice Address - Street 2:SUITE B1B
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-5643
Practice Address - Country:US
Practice Address - Phone:530-906-5836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist