Basic Information
| Provider Information | |||||||||
| NPI: | 1841674983 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CATANIA | ||||||||
| FirstName: | JOHN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4670 N HOLLENBECK AVE | ||||||||
| Address2: | |||||||||
| City: | COVINA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917222755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6265907699 | ||||||||
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| Practice Location | |||||||||
| Address1: | 23701 E EAST FORK RD | ||||||||
| Address2: | |||||||||
| City: | AZUSA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917021477 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262503291 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2015 | ||||||||
| LastUpdateDate: | 06/20/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 21147321 | CA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.