Healthcare Provider Details

I. General information

NPI: 1831782218
Provider Name (Legal Business Name): KATHERINE DONALDSON-FLETCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2021
Last Update Date: 01/11/2025
Certification Date: 01/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2299 MOWRY AVE STE 3-C94538
FREMONT CA
94538-1621
US

IV. Provider business mailing address

556 61ST ST
OAKLAND CA
94609-1269
US

V. Phone/Fax

Practice location:
  • Phone: 510-222-5290
  • Fax:
Mailing address:
  • Phone: 206-818-4630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95171370
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number236174
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95016711
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: