Provider Demographics
NPI:1144336736
Name:FRANK, KATHERINE MARY
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:MARY
Last Name:FRANK
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 1:28081 BRADLEY RD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-2207
Mailing Address - Country:US
Mailing Address - Phone:951-679-7064
Mailing Address - Fax:951-679-4050
Practice Address - Street 1:28081 BRADLEY RD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:CA
Practice Address - Zip Code:92586-2207
Practice Address - Country:US
Practice Address - Phone:951-679-7064
Practice Address - Fax:951-679-4050
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASL1203156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician