Individual
KATHERINE LAURA WIDNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
2625 W ALAMEDA AVE STE 322, BURBANK, CA 91505-4822
(818) 843-9043
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
C141716
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34632300
—
WI
Enumeration date
06/12/2006
Last updated
11/06/2023
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