Healthcare Provider Details

I. General information

NPI: 1477108884
Provider Name (Legal Business Name): KATALENA ANASTASIA SARACINO R.T. (R)(CT)(ARRT)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2019
Last Update Date: 08/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W LUGONIA AVE
REDLANDS CA
92374-9703
US

IV. Provider business mailing address

11171 OAKWOOD DR APT I-102
LOMA LINDA CA
92354
US

V. Phone/Fax

Practice location:
  • Phone: 714-714-6019
  • Fax:
Mailing address:
  • Phone: 714-714-6019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3401X
TaxonomyComputed Tomography Radiologic Technologist
License Number568270
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number568270
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: