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General NPI Number Information
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NPI Number | 1407250020
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Entity Type | Individual
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Provider Name | KATHARINE MARDER MD
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Gender | Female
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Dates
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Enumeration Date | 10/09/2014
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 760 WESTWOOD PLZ STE. 37-384
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City | LOS ANGELES
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State | CA
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Zip | 90024
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Country | US
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Telephone | 310-267-7415
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Fax |
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Provider Business Mailing Address
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Address Line | 2443 FAIR OAKS BLVD # 130
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City | SACRAMENTO
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State | CA
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Zip | 95825-7684
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Country | US
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Telephone | 916-220-0627
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Fax | 980-533-7099
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | A153445
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A153445
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License Number State | CA
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