Individual
LUCILLE KATAVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
6600 MERCY CT STE 110, FAIR OAKS, CA 95628-3150
(916) 966-5404
Mailing address
5420 QUAIL VALLEY RD, PLACERVILLE, CA 95667-8615
(530) 677-9702
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10091
CA
Other
Enumeration date
07/18/2006
Last updated
07/08/2007
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