Provider Demographics
NPI:1861790289
Name:SEEVERS, KATRIONA VICTORIA (CD)
Entity type:Individual
Prefix:MRS
First Name:KATRIONA
Middle Name:VICTORIA
Last Name:SEEVERS
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 S GRANT ST
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-1340
Mailing Address - Country:US
Mailing Address - Phone:650-644-7665
Mailing Address - Fax:
Practice Address - Street 1:622 S GRANT ST
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-1340
Practice Address - Country:US
Practice Address - Phone:650-644-7665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula