Provider Demographics
NPI:1457624678
Name:LE, CATHERINE
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 MARINA VILLAGE PKWY
Mailing Address - Street 2:STE 104
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-1033
Mailing Address - Country:US
Mailing Address - Phone:510-457-8313
Mailing Address - Fax:
Practice Address - Street 1:1050 MARINA VILLAGE PKWY
Practice Address - Street 2:STE 104
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-1033
Practice Address - Country:US
Practice Address - Phone:510-457-8313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-18
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32220111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor