Individual
DR. CATRINA PATRICIA BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
101 S SAN MATEO DR, SAN MATEO, CA 94401-3819
(650) 755-6400
(650) 755-6403
Mailing address
2755 S NORFOLK ST APT 309, SAN MATEO, CA 94403-1673
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F08190605
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y6326908
DRIVER'S LICENSE
CA
Enumeration date
11/26/2019
Last updated
11/26/2019
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