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General NPI Number Information
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NPI Number | 1790550341
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Entity Type | Individual
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Provider Name | CAROLINE KANE NBC-HWC
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Gender | Female
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Dates
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Enumeration Date | 11/22/2023
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 241 EDITH ST
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City | PETALUMA
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State | CA
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Zip | 94952-3223
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Country | US
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Telephone | 415-205-5282
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Fax |
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Provider Business Mailing Address
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Address Line | 241 EDITH ST
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City | PETALUMA
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State | CA
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Zip | 94952-3223
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Country | US
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Telephone | 415-205-5282
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | A-3221624
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License Number State | CA
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