Doctor Name: | KATHERINE WHITLEY |
NPI Number: | 1801224043 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 824671 |
Business Practice Address: | 1260 N Dutton Ave #275 Santa Rosa, CA - 954014659 |
Business Phone Number: | 7072067268 |
Business Fax Number: | 7072067254 |
Mailing Address: | 1260 N Dutton Ave, #275 SANTA ROSA |
State: | CA |
Postal Code: | 954014659 |
Phone Number: | 7072067268 |
Fax Number: | 7072067254 |
NPI Enumeration Date: | 10/25/2013 |
NPI Last Update Date: | 09/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 824671 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |