Provider Demographics
NPI:1679783633
Name:LONDON, CATHY T (LMFT)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:T
Last Name:LONDON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6333 TELEGRAPH AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1359
Mailing Address - Country:US
Mailing Address - Phone:510-862-0775
Mailing Address - Fax:510-397-6458
Practice Address - Street 1:3541 JAMISON WAY # 130
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4301
Practice Address - Country:US
Practice Address - Phone:510-862-0775
Practice Address - Fax:510-252-6533
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT45170106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist