Individual
KATHRYN ROUMBANIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2403 PROFESSIONAL DR, SUITE 102, SANTA ROSA, CA 95403-3007
(707) 284-2950
(707) 284-2955
Mailing address
2403 PROFESSIONAL DR, SUITE 1021, SANTA ROSA, CA 95403-3007
(707) 284-2950
(707) 284-2955
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
4900009RN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
494907000
MEDI-CAL
CA
Enumeration date
10/07/2015
Last updated
10/07/2015
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