Basic Information
| Provider Information | |||||||||
| NPI: | 1629796263 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROUTZEN | ||||||||
| FirstName: | KAITLYN | ||||||||
| MiddleName: | SIERRA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CNM, WH-NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 112 LA CASA VIA STE 300 | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945983059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9252390012 | ||||||||
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| Practice Location | |||||||||
| Address1: | 112 LA CASA VIA | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945983091 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9259393000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2022 | ||||||||
| LastUpdateDate: | 08/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | 95022189 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 364S00000X | 4780 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | 367A00000X | 236286 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.