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General NPI Number Information
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NPI Number | 1467975953
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Entity Type | Individual
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Provider Name | KATHERINE BURNS PA
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Gender | Female
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Dates
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Enumeration Date | 07/17/2017
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 365 HAWTHORNE AVE STE 101
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City | OAKLAND
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State | CA
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Zip | 94609-3115
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Country | US
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Telephone | 510-465-5523
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Fax |
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Provider Business Mailing Address
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Address Line | 4436 MACARTHUR BLVD
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City | OAKLAND
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State | CA
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Zip | 94619-2700
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Country | US
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Telephone |
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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 | 54407
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License Number State | CA
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