Healthcare Provider Details

I. General information

NPI: 1316366891
Provider Name (Legal Business Name): KATHARYN HART DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2014
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1388 S CALIFORNIA BLVD
WALNUT CREEK CA
94596-5125
US

IV. Provider business mailing address

3075 E COVELL BLVD
DAVIS CA
95618-1564
US

V. Phone/Fax

Practice location:
  • Phone: 800-427-7973
  • Fax:
Mailing address:
  • Phone: 530-400-8618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number17393
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: