Provider Demographics
NPI:1871812792
Name:AHIA, CATHY YOUNG (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:YOUNG
Last Name:AHIA
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33502 IRONSIDES DR
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-1541
Mailing Address - Country:US
Mailing Address - Phone:949-272-1661
Mailing Address - Fax:
Practice Address - Street 1:27001 LA PAZ RD
Practice Address - Street 2:SUITE 424B
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5502
Practice Address - Country:US
Practice Address - Phone:949-272-1661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC47117106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist