Provider Demographics
NPI:1881749158
Name:BENNETT, CATHY C (MFT)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:C
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 GREGORY LN BLDG C
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3353
Mailing Address - Country:US
Mailing Address - Phone:925-798-9443
Mailing Address - Fax:925-646-5102
Practice Address - Street 1:200 GREGORY LN BLDG C
Practice Address - Street 2:SUITE 101
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3353
Practice Address - Country:US
Practice Address - Phone:925-798-9443
Practice Address - Fax:925-646-5102
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT24810106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist