Individual
DR. VIENNA GRAYCE KATANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4664 N PENNGROVE WAY STE 100, MERIDIAN, ID 83646-7442
(208) 898-7467
Mailing address
4664 N PENNGROVE WAY STE 100, MERIDIAN, ID 83646-7442
(208) 898-7467
(208) 398-2120
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
13629
CA
207N00000X
Dermatology Physician
20A13629
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/11/2013
Last updated
01/10/2025
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