Basic Information
| Provider Information | |||||||||
| NPI: | 1073886040 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CATER | ||||||||
| FirstName: | HARRIETTE | ||||||||
| MiddleName: | LUCRETIA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 750 N KING RD | ||||||||
| Address2: | APT 901 | ||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951331548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504935000 | ||||||||
| FaxNumber: | 6504962504 | ||||||||
| Practice Location | |||||||||
| Address1: | 3601 MIRANDA AVE | ||||||||
| Address2: | BLDG 2 UNIT 2B1 | ||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504935000 | ||||||||
| FaxNumber: | 6504962504 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2012 | ||||||||
| LastUpdateDate: | 02/21/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | S1002109 | OH | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.