Healthcare Provider Details

I. General information

NPI: 1396433207
Provider Name (Legal Business Name): KATRINA BATACLAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W TOWN AND COUNTRY RD
ORANGE CA
92868-4600
US

IV. Provider business mailing address

300 CONTINENTAL BLVD STE 560
EL SEGUNDO CA
90245-5030
US

V. Phone/Fax

Practice location:
  • Phone: 844-215-2443
  • Fax:
Mailing address:
  • Phone: 323-715-8467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95025000
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: