Provider Demographics
NPI:1871749556
Name:PLATT, KATRINA JANE (DO)
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:JANE
Last Name:PLATT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:KATRINA
Other - Middle Name:JANE
Other - Last Name:KNEHANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:251 CAJON ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5260
Mailing Address - Country:US
Mailing Address - Phone:909-307-0176
Mailing Address - Fax:
Practice Address - Street 1:251 CAJON ST
Practice Address - Street 2:SUITE A
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5260
Practice Address - Country:US
Practice Address - Phone:909-307-0176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10988207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine