Provider Demographics
NPI:1457131674
Name:FROEHLICH, KATHERINE ANN (DNAP, RN, CRNA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:FROEHLICH
Suffix:
Gender:F
Credentials:DNAP, RN, CRNA
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Other - Middle Name:
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Other - Suffix:
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Mailing Address - Street 1:42962 CALA ROSSO
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-3617
Mailing Address - Country:US
Mailing Address - Phone:302-547-5276
Mailing Address - Fax:
Practice Address - Street 1:26520 CACTUS AVENUE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-3927
Practice Address - Country:US
Practice Address - Phone:951-486-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95166511163W00000X
CA95002211367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse