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NPI Code Detail

MEDICARE: KATHLEEN BRANDT FNP

MEDICARE: KATHLEEN BRANDT FNP
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
1363LF0000XFamily Nurse Practitioner95024536CA
2363LP2300XPrimary Care Nurse Practitioner95024536CA

General Provider Information

NPI Number : 1841990603
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN BRANDT FNP
Provider Business Mailing Address
First Line : PO BOX 1100
Second Line :
City : GUALALA
State : CA
Zip : 95445-1100
Country : US
Telephone Number : 707-884-9434
Fax Number :
Provider Business Practice Location Address
First Line : 475 BRUCE ST
Second Line :
City : YREKA
State : CA
Zip : 96097-3474
Country : US
Telephone Number : 530-842-3507
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2023
Last Update Date : 06/19/2026

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