Provider Demographics
NPI:1376389288
Name:FELICITAS, CATHERINE (DNP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:FELICITAS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SPECTRUM CENTER DR STE 400
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4989
Mailing Address - Country:US
Mailing Address - Phone:310-562-5212
Mailing Address - Fax:
Practice Address - Street 1:300 SPECTRUM CENTER DR STE 400
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4989
Practice Address - Country:US
Practice Address - Phone:310-562-5212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030318363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health