Provider Demographics
NPI:1184495905
Name:WHEELER, CATHERINE R
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:R
Last Name:WHEELER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 FAIRWAY VIEW PL APT 1104
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0936
Mailing Address - Country:US
Mailing Address - Phone:951-454-2481
Mailing Address - Fax:
Practice Address - Street 1:9400 FAIRWAY VIEW PL APT 1104
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0936
Practice Address - Country:US
Practice Address - Phone:951-454-2481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMA12423101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor