Basic Information
| Provider Information | |||||||||
| NPI: | 1700911062 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GORCHOFF | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | |||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1601 FRUITVALE AVE | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946012322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105354000 | ||||||||
| FaxNumber: | 5105354128 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 HOSPITAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | VALLEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 84589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7076457316 | ||||||||
| FaxNumber: | 7076450426 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2007 | ||||||||
| LastUpdateDate: | 01/13/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 175M00000X | CNM653 | CA | Y | Other Service Providers | Midwife, Lay |
ID Information
| ID | Type | State | Issuer | Description | FHC71149F | 05 | CA | MEDICAID | HAP71149F | 01 | CA | FPACT | OTHER | ZZZ21677Z | 01 | CA | MEDICARE PART B | OTHER | 05-1070 | 01 | CA | MEDICARE PART A | OTHER |