Healthcare Provider Details

I. General information

NPI: 1922915438
Provider Name (Legal Business Name): KATHERINE BOSSET
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SAN LEANDRO BLVD
SAN LEANDRO CA
94577-1598
US

IV. Provider business mailing address

780 CONTADA CIR
DANVILLE CA
94526-3558
US

V. Phone/Fax

Practice location:
  • Phone: 925-914-5454
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE4025199
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: