Healthcare Provider Details

I. General information

NPI: 1952314510
Provider Name (Legal Business Name): KATRINA BARNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 GRANT RD
MOUNTAIN VIEW CA
94040-4302
US

IV. Provider business mailing address

4182 MANUELA AVE
PALO ALTO CA
94306-3702
US

V. Phone/Fax

Practice location:
  • Phone: 516-993-8804
  • Fax:
Mailing address:
  • Phone: 516-993-8804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number0A95093
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA95093
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: