Katherine Victoria Herzog, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95034447 Issued in CA

Practice address

28200 Highway 189 Ste 2-220
Lake Arrowhead, CA 92352-9700

Phone

(714) 398-5246

NPI assigned

Aug 12, 2020

Last updated

Dec 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: martinrochamd.katherineherzog@126781.advancedmd-direct.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1184235236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28200 HWY 189 STE 02-220, #761",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "923529700",
            "telephone_number": "714-398-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28200 HIGHWAY 189 STE 2-220",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "923529700",
            "telephone_number": "714-398-5246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 N. HWY 173",
            "address_purpose": "LOCATION",
            "city": "Lake Arrowhead",
            "state": "CA",
            "postal_code": "92352",
            "country_code": "US",
            "telephone_number": "909-336-3670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "KATHERINE",
        "middle_name": "VICTORIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95034447",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10015762",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kwangja Lee Hong, CRNA
• Corey K Houmand, DDS
• Lisa James, RN
• Kieth J. Burkart, O.D., a Professional Corporation

• Family Nurse Practitioner in Lake Arrowhead, CA
• Providers in Lake Arrowhead, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.