Provider Demographics
NPI:1265565089
Name:ABBOTT, CATHY LYNN
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:LYNN
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:LYNN
Other - Last Name:KRIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2024 KHATRI CT
Mailing Address - Street 2:
Mailing Address - City:RIVERBANK
Mailing Address - State:CA
Mailing Address - Zip Code:95367-9617
Mailing Address - Country:US
Mailing Address - Phone:209-765-2690
Mailing Address - Fax:
Practice Address - Street 1:2937 VENEMAN AVE STE B240
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-0695
Practice Address - Country:US
Practice Address - Phone:209-919-0058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist