Provider Demographics
NPI:1801105176
Name:CATTOLICO, VICTOR JOHN (PSYD, PSY23576)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:JOHN
Last Name:CATTOLICO
Suffix:
Gender:M
Credentials:PSYD, PSY23576
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7650 NEWCASTLE RD
Mailing Address - Street 2:PO BOX 2130014
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95215-9663
Mailing Address - Country:US
Mailing Address - Phone:209-662-4189
Mailing Address - Fax:
Practice Address - Street 1:7650 NEWCASTLE RD
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95215-9663
Practice Address - Country:US
Practice Address - Phone:209-662-4189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23576103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical