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General NPI Number Information
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NPI Number | 1104793876
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Entity Type | Individual
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Provider Name | KATHERINE L TA-ACA RN
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Gender |
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Dates
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Enumeration Date | 10/18/2025
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Last Update Date | 10/18/2025
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Provider Practice Location Address
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Address Line | 1000 S FREMONT AVE BLDG A9E6TH
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City | ALHAMBRA
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State | CA
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Zip | 91803-8800
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Country | US
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Telephone | 323-986-2137
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 S FREMONT AVE BLDG A9E6TH
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City | ALHAMBRA
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State | CA
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Zip | 91803-8800
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Country | US
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Telephone | 323-986-2137
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 717017
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License Number State | CA
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