Provider Demographics
NPI:1275126070
Name:HALLUM, KATHERINE A D
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A D
Last Name:HALLUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 S CLAUDINA ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-5213
Mailing Address - Country:US
Mailing Address - Phone:805-798-2939
Mailing Address - Fax:
Practice Address - Street 1:898 S CLAUDINA ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-5213
Practice Address - Country:US
Practice Address - Phone:805-798-2939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula