Provider Demographics
NPI:1558743757
Name:VIEIRA, KATHARINE ELISHEVA (RN, NP, MS)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ELISHEVA
Last Name:VIEIRA
Suffix:
Gender:F
Credentials:RN, NP, MS
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:ELISHEVA
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N WIGET LN STE 150
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-5900
Mailing Address - Country:US
Mailing Address - Phone:925-357-6515
Mailing Address - Fax:925-988-0697
Practice Address - Street 1:100 N WIGET LN STE 150
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-5900
Practice Address - Country:US
Practice Address - Phone:925-357-6515
Practice Address - Fax:925-988-0697
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA525555163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscience