Provider Demographics
NPI:1952684144
Name:CLAYPOOLE MCKENZIE, KATHERINE (MS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:CLAYPOOLE MCKENZIE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:CAROLYN
Other - Last Name:CLAYPOOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4150 CLEMENT ST # 116B
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1545
Mailing Address - Country:US
Mailing Address - Phone:415-221-4810
Mailing Address - Fax:
Practice Address - Street 1:4150 CLEMENT ST # 116B
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program