Provider Demographics
NPI:1023129871
Name:CIAMPA, CATHERINE SELEINE (LMFC)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:SELEINE
Last Name:CIAMPA
Suffix:
Gender:F
Credentials:LMFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 MAIN ST
Mailing Address - Street 2:SUITE 216
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-5736
Mailing Address - Country:US
Mailing Address - Phone:530-417-0493
Mailing Address - Fax:530-621-2637
Practice Address - Street 1:681 MAIN ST
Practice Address - Street 2:SUITE 216
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-5736
Practice Address - Country:US
Practice Address - Phone:530-417-0493
Practice Address - Fax:530-621-2637
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT23877106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist