Provider Demographics
NPI:1629582341
Name:OVERLANDER, MARY CATHERINE (FNP)
Entity Type:Individual
Prefix:MISS
First Name:MARY
Middle Name:CATHERINE
Last Name:OVERLANDER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26101 MCBEAN PKWY UNIT 137
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2007
Mailing Address - Country:US
Mailing Address - Phone:805-844-0869
Mailing Address - Fax:
Practice Address - Street 1:26101 MCBEAN PKWY
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2007
Practice Address - Country:US
Practice Address - Phone:661-200-3385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007490363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily