Provider Demographics
NPI:1356551287
Name:THIELEN, CATHERINE ANN (PSYD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:THIELEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18200 YORBA LINDA BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-4043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:714-492-8264
Practice Address - Street 1:19742 MACARTHUR BLVD STE 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2408
Practice Address - Country:US
Practice Address - Phone:714-646-8034
Practice Address - Fax:714-492-8264
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY30762103TC0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health