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General NPI Number Information
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NPI Number | 1174710867
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Entity Type | Individual
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Provider Name | KATHERINE CHRISTINE REDDEN PA
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Gender | Female
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 06/06/2016
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Provider Practice Location Address
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Address Line | 24022 CALLE DE LA PLATA SUTIE 500
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3626
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Country | US
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Telephone | 949-837-1578
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Fax |
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Provider Business Mailing Address
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Address Line | 3080 BRISTOL ST SUITE 600
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City | COSTA MESA
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State | CA
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Zip | 92626-3093
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Country | US
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Telephone | 714-445-0220
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA19354
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License Number State | CA
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