Provider Demographics
NPI:1194423392
Name:GALVAN, CATHERINE KRISTINE
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:KRISTINE
Last Name:GALVAN
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 1:2850 CAMINO HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:CAMINO
Mailing Address - State:CA
Mailing Address - Zip Code:95709-9512
Mailing Address - Country:US
Mailing Address - Phone:703-217-9631
Mailing Address - Fax:
Practice Address - Street 1:2850 CAMINO HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:CAMINO
Practice Address - State:CA
Practice Address - Zip Code:95709-9512
Practice Address - Country:US
Practice Address - Phone:703-217-9631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA777463163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management