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General NPI Number Information
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NPI Number | 1306680483
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Entity Type | Individual
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Provider Name | MADISON KATZENMEYER
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Gender | Female
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Dates
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Enumeration Date | 06/24/2024
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 2035 LYNDELL TER STE 120
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City | DAVIS
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State | CA
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Zip | 95616-6222
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Country | US
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Telephone | 800-478-8837
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Fax | 530-491-2907
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Provider Business Mailing Address
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Address Line | 2035 LYNDELL TER STE 120
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City | DAVIS
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State | CA
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Zip | 95616-6222
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Country | US
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Telephone | 800-478-8837
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Fax | 530-491-2907
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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 | PA65895
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License Number State | CA
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