Individual
KATHERINE MATTISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
(951) 486-4000
Mailing address
11175 CAMPUS ST, CSP 11015, LOMA LINDA, CA 92350-1700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP95001682
CA
Other
Enumeration date
01/17/2015
Last updated
01/17/2015
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