Provider Demographics
NPI:1821394651
Name:KLEMZ, CATHY LYNN
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:LYNN
Last Name:KLEMZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 BROADWAY
Mailing Address - Street 2:1
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-2569
Mailing Address - Country:US
Mailing Address - Phone:650-697-0728
Mailing Address - Fax:
Practice Address - Street 1:348 BROADWAY
Practice Address - Street 2:1
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-2569
Practice Address - Country:US
Practice Address - Phone:650-697-0728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist