MEDICARE: KATHERINE ANNE MORENO ARNP

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	363L00000X	Nurse Practitioner	95024252	CA

General Provider Information

NPI Number	:	1346527066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE ANNE MORENO ARNP

Provider Business Mailing Address
First Line	:	700 GARDEN VIEW CT STE 204
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-2478
Country	:	US
Telephone Number	:	607-452-6334
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 GARDEN VIEW CT STE 204
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-2478
Country	:	US
Telephone Number	:	402-844-8284
Fax Number	:

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

Provider Enumeration Date	:	11/09/2011
Last Update Date	:	01/21/2026

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