Provider Demographics
NPI:1871509018
Name:NELSON, CATHERINE STARR (MD,MPH)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:STARR
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 S FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-7913
Mailing Address - Country:US
Mailing Address - Phone:408-992-4971
Mailing Address - Fax:408-992-4962
Practice Address - Street 1:660 S FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-7913
Practice Address - Country:US
Practice Address - Phone:408-992-4971
Practice Address - Fax:408-992-4962
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95264208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH89376Medicare UPIN