Provider Demographics
NPI:1356157614
Name:WINGERT, KATHARINE MACKNIGHT (CBD)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:MACKNIGHT
Last Name:WINGERT
Suffix:
Gender:F
Credentials:CBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24722 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6226
Mailing Address - Country:US
Mailing Address - Phone:714-296-2560
Mailing Address - Fax:
Practice Address - Street 1:24722 5TH ST
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6226
Practice Address - Country:US
Practice Address - Phone:951-249-3710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula