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NPI Code Detail

MEDICARE: KATERINE PAPADOPOULOS NP

MEDICARE: KATERINE PAPADOPOULOS 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
1363LA2200XAdult Health Nurse Practitioner20425CA

General Provider Information

NPI Number : 1639465636
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATERINE PAPADOPOULOS NP
Provider Business Mailing Address
First Line : 109 LIVE OAK DR
Second Line :
City : PETALUMA
State : CA
Zip : 94952-1016
Country : US
Telephone Number : 707-291-3293
Fax Number :
Provider Business Practice Location Address
First Line : 1221 N DUTTON AVE
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4607
Country : US
Telephone Number : 707-543-8360
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2011
Last Update Date : 11/14/2011

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Directions to “ KATERINE PAPADOPOULOS NP” Practice Location

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