Healthcare Provider Details

I. General information

NPI: 1346290004
Provider Name (Legal Business Name): ANNETTE KATANO R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 WILLOW RD MP-170A
MENLO PARK CA
94025-2539
US

IV. Provider business mailing address

1917 SANTA FE DR STOCKTON
STOCKTON CA
95209-1348
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number253980
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: