Provider Demographics
NPI:1639590326
Name:ZENDEJAS, CATHERINE (MSN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:ZENDEJAS
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:ZENDEJAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP-PC
Mailing Address - Street 1:164 SHORT BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-4642
Mailing Address - Country:US
Mailing Address - Phone:619-300-6200
Mailing Address - Fax:
Practice Address - Street 1:20 DOC STONE RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-4515
Practice Address - Country:US
Practice Address - Phone:619-300-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-23
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA790854163W00000X
VA0024177372363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse