Provider Demographics
NPI:1538457502
Name:MCCARTHY, KATHERINE (L AC)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2120
Mailing Address - Country:US
Mailing Address - Phone:415-359-3160
Mailing Address - Fax:
Practice Address - Street 1:902 SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-2120
Practice Address - Country:US
Practice Address - Phone:415-359-3160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12445171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist