Provider Demographics
NPI:1700911062
Name:GORCHOFF, CATHERINE (CNM)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:GORCHOFF
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 FRUITVALE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-2322
Mailing Address - Country:US
Mailing Address - Phone:510-535-4000
Mailing Address - Fax:510-535-4128
Practice Address - Street 1:210 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:84589
Practice Address - Country:US
Practice Address - Phone:707-645-7316
Practice Address - Fax:707-645-0426
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACNM653175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC71149FMedicaid
CAHAP71149FOtherFPACT
CAZZZ21677ZOtherMEDICARE PART B
CA05-1070OtherMEDICARE PART A