MEDICARE: DR. KATARINA SEPULVEDA DC, LCCE, DOULA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula	0008	NV
2	111N00000X	Chiropractor	B01604	NV

General Provider Information

NPI Number	:	1164887378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATARINA SEPULVEDA DC, LCCE, DOULA

Provider Business Mailing Address
First Line	:	1601 E BASIN AVE STE 304
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89060-4612
Country	:	US
Telephone Number	:	775-751-3316
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 E BASIN AVE STE 304
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89060-4612
Country	:	US
Telephone Number	:	775-751-3316
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2015
Last Update Date	:	01/06/2023

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