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NPI Code Detail

MEDICARE: KATHLEEN CARLSON NP

MEDICARE: KATHLEEN CARLSON NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner95010711CA
2363LF0000XFamily Nurse Practitioner4704178248MI

General Provider Information

NPI Number : 1629180161
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN CARLSON NP
Provider Business Mailing Address
First Line : 1 EMBARCADERO CTR STE 1900
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94111-3723
Country : US
Telephone Number : 415-658-6791
Fax Number :
Provider Business Practice Location Address
First Line : 7740 EL CAMINO REAL STE F
Second Line :
City : CARLSBAD
State : CA
Zip : 92009-8514
Country : US
Telephone Number : 619-232-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 06/06/2024

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Directions to “ KATHLEEN CARLSON NP” Practice Location

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