Provider Demographics
NPI:1033805304
Name:CROCE, KATHRYN (RN)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:CROCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:ISENHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2995 WOODSIDE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2447
Mailing Address - Country:US
Mailing Address - Phone:650-275-8420
Mailing Address - Fax:
Practice Address - Street 1:2995 WOODSIDE RD STE 300
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:CA
Practice Address - Zip Code:94062-2447
Practice Address - Country:US
Practice Address - Phone:650-275-8420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95318629163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health