Provider Demographics
NPI:1811239866
Name:CATHEY BLAU
Entity type:Organization
Organization Name:CATHEY BLAU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:BLAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:760-367-2117
Mailing Address - Street 1:87079 AMBOY RD
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-8533
Mailing Address - Country:US
Mailing Address - Phone:760-367-2117
Mailing Address - Fax:760-367-2117
Practice Address - Street 1:6528A HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92277-3228
Practice Address - Country:US
Practice Address - Phone:760-367-2117
Practice Address - Fax:760-367-2117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-17
Last Update Date:2013-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS67021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty