Basic Information
| Provider Information | |||||||||
| NPI: | 1831568013 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEUTNER | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | REBECCA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2520 RYAN RD | ||||||||
| Address2: | #38 | ||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945182679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7076880035 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 PASTEUR DR | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943052200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507234000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2015 | ||||||||
| LastUpdateDate: | 12/14/2018 | ||||||||
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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 | 363L00000X | 95003135 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 364S00000X | 95003135 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist |
ID Information
| ID | Type | State | Issuer | Description | 95003135 | 01 | CA | CALIFORNIA BOARD OF NURSING, NURSE PRACITIONER LICENSE NUMBER | OTHER |