Provider Demographics
NPI:1881879575
Name:VIEIRA-BAKER, CATHERINE C (PHD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:C
Last Name:VIEIRA-BAKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-5315
Mailing Address - Country:US
Mailing Address - Phone:508-328-9881
Mailing Address - Fax:
Practice Address - Street 1:321 HOPE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2209
Practice Address - Country:US
Practice Address - Phone:401-421-1405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-01
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00751103TC0700X
VA0810002712103TC0700X
MA7895103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA45102Medicaid
MA45102Medicaid