Provider Demographics
NPI:1720389752
Name:BERCHTOLD, CATHERINE
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:BERCHTOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KITTY
Other - Middle Name:
Other - Last Name:BERCHTOLD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1800 MOUNT VERNON AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-3302
Mailing Address - Country:US
Mailing Address - Phone:661-868-0417
Mailing Address - Fax:661-868-0261
Practice Address - Street 1:1800 MOUNT VERNON AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3302
Practice Address - Country:US
Practice Address - Phone:661-868-0417
Practice Address - Fax:661-868-0261
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA376064163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse