Provider Demographics
NPI:1891061701
Name:WEINBERG, KATHY ANNE (RN, CNS)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:ANNE
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:ANNE
Other - Last Name:WOLFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4507 GATETREE CIR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6031
Mailing Address - Country:US
Mailing Address - Phone:925-425-9244
Mailing Address - Fax:
Practice Address - Street 1:4507 GATETREE CIR
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6031
Practice Address - Country:US
Practice Address - Phone:925-425-9244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-25
Last Update Date:2012-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA357523364SC0200X
CA3435364SC0200X
NJ26NC06155900364SC0200X
NJ26NR06155900364SC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine