Provider Demographics
NPI:1881832301
Name:RANDALL, KATHARINE ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHARINE
Middle Name:ELIZABETH
Last Name:RANDALL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 GREENWICH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-3306
Mailing Address - Country:US
Mailing Address - Phone:415-440-4494
Mailing Address - Fax:415-440-5575
Practice Address - Street 1:2400 GREENWICH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-3306
Practice Address - Country:US
Practice Address - Phone:415-440-4494
Practice Address - Fax:415-440-5575
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31110111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor