Provider Demographics
NPI:1750956355
Name:MORELAND, CATHERINE ALEXANDRA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ALEXANDRA
Last Name:MORELAND
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CROSSROADS BLVD # 330
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8674
Mailing Address - Country:US
Mailing Address - Phone:831-233-9866
Mailing Address - Fax:
Practice Address - Street 1:1811 NOVATO BLVD APT 14
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-2940
Practice Address - Country:US
Practice Address - Phone:831-233-9866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31659235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist