Healthcare Provider Details
I. General information
NPI: 1851406532
Provider Name (Legal Business Name): KRISTEN A CATES CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/20/2006
Last Update Date: 06/12/2020
Certification Date: 06/12/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2051 JOHN JONES RD
DAVIS CA
95616-9701
US
IV. Provider business mailing address
2051 JOHN JONES RD
DAVIS CA
95616-9701
US
V. Phone/Fax
- Phone: 530-758-2060
- Fax:
- Phone: 530-758-2060
- Fax: 530-758-8490
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | NM1657 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: