Provider Demographics
NPI:1083445431
Name:PAUTZ, KATARINA BALTAYAN
Entity type:Individual
Prefix:
First Name:KATARINA
Middle Name:BALTAYAN
Last Name:PAUTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 494100
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-4100
Mailing Address - Country:US
Mailing Address - Phone:530-245-5805
Mailing Address - Fax:
Practice Address - Street 1:322 W CENTER ST STE 6
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-2900
Practice Address - Country:US
Practice Address - Phone:530-841-7190
Practice Address - Fax:530-841-7194
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program