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General NPI Number Information
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NPI Number | 1962293183
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Entity Type | Individual
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Provider Name | KATIE ELIZABETH KAKOS RN
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Gender | Female
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 2751 NAPA VALLEY CORPORATE DR
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City | NAPA
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State | CA
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Zip | 94558-6216
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Country | US
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Telephone | 707-253-6172
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Fax |
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Provider Business Mailing Address
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Address Line | 515 MCKENZIE DR
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City | DIXON
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State | CA
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Zip | 95620-2329
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Country | US
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Telephone | 707-761-1690
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 95184524
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License Number State | CA
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