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Individual

KATE ROSE SHANTAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2400 MISSION ST, SAN MARINO, CA 91108-1632
(626) 403-8999
Mailing address
152 S HAYWORTH AVE APT 6, LOS ANGELES, CA 90048-3616
(415) 844-0831

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95027343
CA

Other

Enumeration date
09/22/2023
Last updated
09/22/2023
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