Provider Demographics
NPI:1164574331
Name:HORN, KAREN YURCH (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:YURCH
Last Name:HORN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 DONALD DR
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3651
Mailing Address - Country:US
Mailing Address - Phone:925-254-8608
Mailing Address - Fax:
Practice Address - Street 1:2587 MERCED ST.
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577
Practice Address - Country:US
Practice Address - Phone:510-351-3553
Practice Address - Fax:510-351-3585
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN297159363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACF226ZMedicare UPIN
CAZZZ07334ZMedicare PIN