Healthcare Provider Details

I. General information

NPI: 1831568013
Provider Name (Legal Business Name): KATHERINE REBECCA ALLEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2015
Last Update Date: 06/17/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR
PALO ALTO CA
94305-2200
US

IV. Provider business mailing address

7500 BARTON RD
GRANITE BAY CA
95746-9461
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-4000
  • Fax:
Mailing address:
  • Phone: 707-688-0035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number95003135
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95003135
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: