| Doctor Name: | MRS. CATHERINE ANN TIETJEN |
| NPI Number: | 1174656623 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.M.F.T., R.N. |
| License Number: | 376558 |
| Business Practice Address: | 370 9th St Crescent City, CA - 955313432 |
| Business Phone Number: | 7074644349 |
| Business Fax Number: | 7074644572 |
| Mailing Address: | 370 9th St, CRESCENT CITY |
| State: | CA |
| Postal Code: | 955313432 |
| Phone Number: | 7074644349 |
| Fax Number: | 7074644572 |
| NPI Enumeration Date: | 03/13/2007 |
| NPI Last Update Date: | 07/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 376558 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |