Healthcare Provider Details

I. General information

NPI: 1326864471
Provider Name (Legal Business Name): KATIE NITZBERG DNP-CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2024
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 CALIFORNIA ST RM 111
SAN FRANCISCO CA
94118-1504
US

IV. Provider business mailing address

3838 CALIFORNIA ST RM 111
SAN FRANCISCO CA
94118-1504
US

V. Phone/Fax

Practice location:
  • Phone: 415-387-9293
  • Fax:
Mailing address:
  • Phone: 415-387-9293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP95033360
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: