Healthcare Provider Details

I. General information

NPI: 1295190890
Provider Name (Legal Business Name): KATE ELIZABETH WEST FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2015
Last Update Date: 05/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 ALAMO AVE STE 2
WEED CA
96094-2352
US

IV. Provider business mailing address

PO BOX 277
BIEBER CA
96009-0277
US

V. Phone/Fax

Practice location:
  • Phone: 530-938-3491
  • Fax:
Mailing address:
  • Phone: 530-294-5375
  • Fax: 530-294-5801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95003491
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: