Healthcare Provider Details

I. General information

NPI: 1790806388
Provider Name (Legal Business Name): KATHARINE DELANO ALDRICH CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 OCONNOR DR SUITE 300
SAN JOSE CA
95128-1633
US

IV. Provider business mailing address

885 S WINCHESTER BLVD APT. 243
SAN JOSE CA
95128-2947
US

V. Phone/Fax

Practice location:
  • Phone: 408-287-4441
  • Fax: 408-287-4442
Mailing address:
  • Phone: 646-685-7413
  • Fax: 408-287-4441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1737
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: