MEDICARE: CYNTHIA TINNAH KATASI RN

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	163W00000X	Registered Nurse	95362126	CA

General Provider Information

NPI Number	:	1194675330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA TINNAH KATASI RN

Provider Business Mailing Address
First Line	:	11957 COBBLEBROOK DR
Second Line	:
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95742-6939
Country	:	US
Telephone Number	:	661-212-5670
Fax Number	:

Provider Business Practice Location Address
First Line	:	11957 COBBLEBROOK DR
Second Line	:
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95742-6939
Country	:	US
Telephone Number	:	661-212-5670
Fax Number	:

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

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

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