Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY17301 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY17301 | CA |
NPI | 1003094962 |
---|---|
Provider Name | Dr. Catherine Jane Prudhomme |
First Address | Nevada City, CA 95959-2430 |
Second Address | Represa, CA 95671-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2008 |
Last Update Date | 26/01/2013 |