Provider Demographics
NPI:1477108884
Name:SARACINO, KATALENA ANASTASIA (RT (R)(CT)(ARRT))
Entity Type:Individual
Prefix:
First Name:KATALENA
Middle Name:ANASTASIA
Last Name:SARACINO
Suffix:
Gender:F
Credentials:RT (R)(CT)(ARRT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11171 OAKWOOD DR
Mailing Address - Street 2:APT I-102
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354
Mailing Address - Country:US
Mailing Address - Phone:714-714-6019
Mailing Address - Fax:
Practice Address - Street 1:1901 W LUGONIA AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-9703
Practice Address - Country:US
Practice Address - Phone:714-714-6019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-03
Last Update Date:2019-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5682702471C3402X, 2471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography