Provider Demographics
NPI:1992942478
Name:KAN, CATHERINE ANNE (FNP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANNE
Last Name:KAN
Suffix:
Gender:F
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:SUITE 160A
Mailing Address - Street 2:CASTRO STREET AND DUBOCE AVENUE
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114
Mailing Address - Country:US
Mailing Address - Phone:415-600-6616
Mailing Address - Fax:
Practice Address - Street 1:SUITE 160A
Practice Address - Street 2:CASTRO STREET AND DUBOCE AVENUE
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114
Practice Address - Country:US
Practice Address - Phone:415-600-6616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA710427163W00000X
NJ26NR11166600163W00000X
CA18765363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse