Provider Demographics
NPI:1144739236
Name:ENTREKIN, KATHERINE (OTS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:ENTREKIN
Suffix:
Gender:F
Credentials:OTS
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:
Other - Last Name:ENTREKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5893 VALLEJO ST
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-2625
Mailing Address - Country:US
Mailing Address - Phone:530-277-8877
Mailing Address - Fax:
Practice Address - Street 1:425 DIVISADERO ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-2242
Practice Address - Country:US
Practice Address - Phone:415-551-0975
Practice Address - Fax:415-551-0975
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program