| Doctor Name: | MS. KATHY AGNESE |
| NPI Number: | 1003047663 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 724431 |
| Business Practice Address: | 14644b Lakeshore Dr Clearlake, CA - 954229290 |
| Business Phone Number: | 7079951606 |
| Business Fax Number: | 7079950309 |
| Mailing Address: | 14644b Lakeshore Dr, CLEARLAKE |
| State: | CA |
| Postal Code: | 954229290 |
| Phone Number: | 7079951606 |
| Fax Number: | 7079950309 |
| NPI Enumeration Date: | 07/30/2009 |
| NPI Last Update Date: | 07/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | 724431 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |