Healthcare Provider Details

I. General information

NPI: 1174507701
Provider Name (Legal Business Name): KATHARINA CHRISTINE WELBORN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 12/30/2019
Certification Date: 12/30/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8605 AUBURN FOLSOM RD
GRANITE BAY CA
95746-6202
US

IV. Provider business mailing address

8700 AURBURN FOLSOM RD SUITE 300
GRANITE BAY CA
95746-9501
US

V. Phone/Fax

Practice location:
  • Phone: 916-872-1120
  • Fax: 916-872-1125
Mailing address:
  • Phone: 916-872-1120
  • Fax: 916-872-1125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB01061
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberB01061
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-29303
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: