Provider Demographics
NPI:1932195765
Name:BAYER, CATHERINE ANN (PHD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:BAYER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:BAYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 2453
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-0453
Mailing Address - Country:US
Mailing Address - Phone:707-546-8209
Mailing Address - Fax:
Practice Address - Street 1:4605 HIDDEN OAKS RD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-9541
Practice Address - Country:US
Practice Address - Phone:707-546-8209
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC12476 INACTIVE106H00000X
CAPSY9696103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
6137427OtherUSBH
1935063OtherFIRST HEALTH
0005468708OtherAETNA
CAPSY096961Medicaid
CAPSY096961Medicaid