Healthcare Provider Details

I. General information

NPI: 1235879784
Provider Name (Legal Business Name): KATHERINE ANGELA GOCHINGCO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 03/31/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 W WHITTIER BLVD
MONTEBELLO CA
90640-4735
US

IV. Provider business mailing address

833 W WHITTIER BLVD
MONTEBELLO CA
90640-4735
US

V. Phone/Fax

Practice location:
  • Phone: 323-712-4811
  • Fax: 844-302-8678
Mailing address:
  • Phone: 323-712-4811
  • Fax: 844-302-8678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95183203
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: