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General NPI Number Information
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NPI Number | 1629750922
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Entity Type | Individual
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Provider Name | KATHERINE GRACE WOOD RN
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Gender | Female
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Dates
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Enumeration Date | 08/04/2023
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 1037 N LAKE AVE
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City | PASADENA
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State | CA
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Zip | 91104-4521
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Country | US
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Telephone | 626-798-0706
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Fax |
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Provider Business Mailing Address
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Address Line | 650 S LAKE AVE UNIT 11
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City | PASADENA
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State | CA
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Zip | 91106-3964
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Country | US
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Telephone | 419-957-7410
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 95201808
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License Number State | CA
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