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General NPI Number Information
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NPI Number | 1154389153
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Entity Type | Individual
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Provider Name | CATHERINE WILLENBORG PAC
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Gender | Female
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 13400 E SHEA BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5499
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Country | US
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Telephone | 480-301-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 8601 N SENDERO TRES M
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City | PARADISE VALLEY
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State | AZ
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Zip | 85253-2258
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Country | US
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Telephone | 775-771-1824
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA972
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10627
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License Number State | AZ
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