Provider Demographics
NPI:1295793057
Name:LAMPKIN, KATHI (NP)
Entity type:Individual
Prefix:
First Name:KATHI
Middle Name:
Last Name:LAMPKIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 30TH STREET
Mailing Address - Street 2:SUITE 407
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3245
Mailing Address - Country:US
Mailing Address - Phone:510-419-0282
Mailing Address - Fax:510-419-0273
Practice Address - Street 1:350 30TH STREET
Practice Address - Street 2:SUITE 407
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3245
Practice Address - Country:US
Practice Address - Phone:510-419-0276
Practice Address - Fax:510-419-0273
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP13829363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMMM00345MMedicare ID - Type Unspecified