Provider Demographics
NPI:1770639825
Name:AQUINO, KATHERINE A (OD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:AQUINO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:900 S ELISEO DR
Mailing Address - Street 2:STE 102
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2152
Mailing Address - Country:US
Mailing Address - Phone:415-461-8200
Mailing Address - Fax:415-461-4627
Practice Address - Street 1:1750 EL CAMINO REAL
Practice Address - Street 2:SUITE 103
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3228
Practice Address - Country:US
Practice Address - Phone:650-692-2020
Practice Address - Fax:650-692-1441
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2020-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA11459T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist