Provider Demographics
NPI:1598807729
Name:HAUPT-KATSCH, KATHLEEN T
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:T
Last Name:HAUPT-KATSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KATRINA
Other - Middle Name:T
Other - Last Name:HAUPT-KATSCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD, CDE
Mailing Address - Street 1:1800 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1730
Mailing Address - Country:US
Mailing Address - Phone:510-752-6097
Mailing Address - Fax:
Practice Address - Street 1:KAISER PERMANENTE HOSPITAL
Practice Address - Street 2:KAISER PERMANENTE MEDICAL GROUP, INC
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612
Practice Address - Country:US
Practice Address - Phone:510-625-5987
Practice Address - Fax:510-625-5305
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL718641133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered