Basic Information
| Provider Information | |||||||||
| NPI: | 1417935081 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRENETTE | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | THERESE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 10666 N TORREY PINES RD | ||||||||
| Address2: | N200 | ||||||||
| City: | LA JOLLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920371027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585544310 | ||||||||
| FaxNumber: | 8585543009 | ||||||||
| Practice Location | |||||||||
| Address1: | 10666 N TORREY PINES RD | ||||||||
| Address2: | N200 | ||||||||
| City: | LA JOLLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920371027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585544310 | ||||||||
| FaxNumber: | 8585543009 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2006 | ||||||||
| LastUpdateDate: | 05/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 05/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0008X | A80461 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hepatology | 207RG0100X | A80461 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 280753901 | 05 | TX | MEDICAID | 2315021 | 05 | LA | MEDICAID | 1417935081 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | 280753902 | 05 | TX | MEDICAID | 00A804610 | 05 | CA | MEDICAID | P01030946 | 01 | TX | RR MEDICARE | OTHER |