Provider Demographics
NPI:1760182810
Name:FOLSOM, KATHRYN (FNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:FOLSOM
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 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:619-713-7880
Mailing Address - Fax:
Practice Address - Street 1:278 TOWN CENTER PKWY STE 105
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-5809
Practice Address - Country:US
Practice Address - Phone:619-713-7880
Practice Address - Fax:619-449-2408
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023547363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily