Basic Information
Provider Information
NPI: 1013538768
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHING
FirstName: KATHERINE
MiddleName: ACHACOSO
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 982 MISSION ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941032911
CountryCode: US
TelephoneNumber: 4155978000
FaxNumber: 4155978004
Practice Location
Address1: 982 MISSION ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941032911
CountryCode: US
TelephoneNumber: 4155978000
FaxNumber: 4155978004
Other Information
ProviderEnumerationDate: 05/05/2020
LastUpdateDate: 11/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X95013572CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home