Whisman, Kathleen Ellen
Whisman, Kathleen Ellen is an sole proprietor health care provider with primary practice located at 678 Petaluma Ave , Sebastopol CA 95472-4217. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Whisman, Kathleen Ellen can be contacted via phone (707) 823-6997.Contact Information
Primary practice address
678 Petaluma Ave
Sebastopol CA 95472-4217
Phone: (707) 823-6997
Fax: (707) 829-3709
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | G79463 | California |
Profile Details
| NPI number | 1124179353 |
|---|---|
| LBN Legal business name | Whisman, Kathleen Ellen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 15th, 2007 |
| Last updated | Jul 20th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124179353 | NPPES |
| California | MEDICAID | 00G794630 |
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