Provider Demographics
NPI:1629304159
Name:RIVER, CATHERINE A
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:RIVER
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:PO BOX 591823
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94159-1823
Mailing Address - Country:US
Mailing Address - Phone:805-280-1899
Mailing Address - Fax:
Practice Address - Street 1:12300 COUGAR LN SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-3527
Practice Address - Country:US
Practice Address - Phone:805-280-1899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-17
Last Update Date:2009-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion