Provider Demographics
NPI:1881381804
Name:LARIOS, KATHERINE SAMANTHA
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SAMANTHA
Last Name:LARIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 PRICE AVE
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1428
Mailing Address - Country:US
Mailing Address - Phone:415-678-9916
Mailing Address - Fax:
Practice Address - Street 1:604 PRICE AVE
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1428
Practice Address - Country:US
Practice Address - Phone:415-678-9916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker