Healthcare Provider Details

I. General information

NPI: 1265362032
Provider Name (Legal Business Name): KATHERINE ANNE KOCSIS NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 HEALTH CENTER DR
SAN DIEGO CA
92123-2700
US

IV. Provider business mailing address

4822 VISTA ARROYO
LA MESA CA
91941-4362
US

V. Phone/Fax

Practice location:
  • Phone: 858-939-3400
  • Fax:
Mailing address:
  • Phone: 717-856-4002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number95041437
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number95466643
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN760709
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: