Healthcare Provider Details

I. General information

NPI: 1528280559
Provider Name (Legal Business Name): CATHERINE WEST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 N. DUTTON AVE
SANTA ROSA CA
95401
US

IV. Provider business mailing address

1110 N. DUTTON AVE
SANTA ROSA CA
95401
US

V. Phone/Fax

Practice location:
  • Phone: 707-535-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081H0002X
TaxonomyHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
License NumberG49176
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: