Provider Demographics
NPI: | 1598044844 |
---|---|
Name: | KATO, ELLEN O'MALLEY (FNP) |
Entity type: | Individual |
Prefix: | |
First Name: | ELLEN |
Middle Name: | O'MALLEY |
Last Name: | KATO |
Suffix: | |
Gender: | |
Credentials: | FNP |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2 EMBARCADERO CTR LBBY LEVEL |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN FRANCISCO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94111-3823 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 415-578-3100 |
Mailing Address - Fax: | 415-291-0489 |
Practice Address - Street 1: | 2 EMBARCADERO CTR LBBY LEVEL |
Practice Address - Street 2: | |
Practice Address - City: | SAN FRANCISCO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94111-3823 |
Practice Address - Country: | US |
Practice Address - Phone: | 888-663-6331 |
Practice Address - Fax: | 415-252-7176 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2011-08-04 |
Last Update Date: | 2025-03-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 761433 | 163W00000X |
CA | 21049 | 363LF0000X, 363L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
No | 163W00000X | Nursing Service Providers | Registered Nurse | |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |