Basic Information
| Provider Information | |||||||||
| NPI: | 1902004880 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEVERSON-BUSH | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | DENISE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3632 CLAYTON RD | ||||||||
| Address2: | NO. 201 | ||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945215186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9258252764 | ||||||||
| FaxNumber: | 9258252764 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 MYRTLE ST | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946072525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108393800 | ||||||||
| FaxNumber: | 5108393888 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2007 | ||||||||
| LastUpdateDate: | 07/26/2010 | ||||||||
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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 | 106H00000X | MFC47974 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.