Individual
KATHLEEN JO POULSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
215 ALVARADO AVE, LOS ALTOS, CA 94022-1221
(650) 868-0771
Mailing address
215 ALVARADO AVE, LOS ALTOS, CA 94022-1221
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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