Provider Demographics
NPI:1306997820
Name:MULVEY, KATHERINE (OD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:MULVEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7780 N FRESNO ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2413
Mailing Address - Country:US
Mailing Address - Phone:559-435-2060
Mailing Address - Fax:559-435-9060
Practice Address - Street 1:7780 N FRESNO ST
Practice Address - Street 2:SUITE 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2413
Practice Address - Country:US
Practice Address - Phone:559-435-2060
Practice Address - Fax:559-435-9060
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 8815 TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist