Individual
CATHERINE WILLKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY
Contact information
Practice address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4170
(831) 454-4663
Mailing address
PO BOX 962, SANTA CRUZ, CA 95061-0962
(831) 454-4170
(831) 454-4663
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 20380
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY 20380
PSYCHOLOGIST #
CA
01
—
ZZZ91891Z
MEDICARE GROUP ID#
CA
01
—
ZZZ91892Z
MEDICARE GROUP ID#
CA
01
—
ZZZ92073Z
MEDICARE GROUP ID#
CA
01
—
ZZZ92076Z
MEDICARE GROUP ID#
CA
Enumeration date
10/18/2006
Last updated
05/01/2017
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