Provider Demographics
NPI:1851199343
Name:REA, KATHRYN MARIE (CNM)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIE
Last Name:REA
Suffix:
Gender:
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 LAWSON RD
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:94707-1018
Mailing Address - Country:US
Mailing Address - Phone:415-913-0346
Mailing Address - Fax:
Practice Address - Street 1:146 LAWSON RD
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:CA
Practice Address - Zip Code:94707-1018
Practice Address - Country:US
Practice Address - Phone:415-913-0346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236524176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife