Individual
DR. KATHERINE ROSE LAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, PMHNP-BC
Contact information
Practice address
855 E MADISON AVE, EL CAJON, CA 92020-3819
(619) 440-2751
(619) 440-2945
Mailing address
3050 RUE DORLEANS, UNIT 382, SAN DIEGO, CA 92110-5927
(512) 571-0440
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
840984
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95002763
CA
Other
Enumeration date
03/07/2014
Last updated
09/21/2020
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