MEDICARE: KATHERINE BABER NP

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	363LF0000X	Family Nurse Practitioner	95013340	CA

General Provider Information

NPI Number	:	1245876101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE BABER NP

Provider Business Mailing Address
First Line	:	4211 HAINES ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92109-5302
Country	:	US
Telephone Number	:	443-504-2725
Fax Number	:

Provider Business Practice Location Address
First Line	:	3671 FIFTH AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-4218
Country	:	US
Telephone Number	:	619-295-2929
Fax Number	:

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

Provider Enumeration Date	:	11/25/2019
Last Update Date	:	11/25/2019

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