Provider Demographics
NPI:1457408072
Name:AISNER, CATHERINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:AISNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 LAKE TAHOE BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150-7104
Mailing Address - Country:US
Mailing Address - Phone:530-541-6696
Mailing Address - Fax:530-541-1868
Practice Address - Street 1:2311 LAKE TAHOE BLVD STE 3
Practice Address - Street 2:
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-7104
Practice Address - Country:US
Practice Address - Phone:530-541-6696
Practice Address - Fax:530-541-1868
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10543103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist