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General NPI Number Information
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NPI Number | 1487748943
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Entity Type | Individual
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Provider Name | KATRINA CAROL GROVES-REHWALDT MD
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 2960 CAMINO DIABLO STE 105
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City | WALNUT CREEK
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State | CA
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Zip | 94597-3945
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Country | US
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Telephone | 800-892-2695
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Fax |
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Provider Business Mailing Address
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Address Line | 2960 CAMINO DIABLO STE 105
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City | WALNUT CREEK
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State | CA
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Zip | 94597-3945
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Country | US
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Telephone | 800-892-2695
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | MD19537
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | G69202
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License Number State | CA
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