Healthcare Provider Details

I. General information

NPI: 1871428789
Provider Name (Legal Business Name): MARY FRANCES KLOTZBACH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

761 CARLA ST
LIVERMORE CA
94550-2350
US

IV. Provider business mailing address

761 CARLA ST
LIVERMORE CA
94550-2350
US

V. Phone/Fax

Practice location:
  • Phone: 925-784-1318
  • Fax: 925-449-0336
Mailing address:
  • Phone: 925-784-1318
  • Fax: 925-449-0336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number346726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: