Katherine Aldrich, NP
Individual provider Active NPI Adult Health Nurse Practitioner · Santa Rosa, CA
NPI 1194995563 · NPPES record last updated Nov 30, 2020
Key facts
- NPI
- 1194995563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 270798 (CA)
- Practice address
- 1165 Montgomery Dr
Santa Rosa, CA 95405-4801 - Phone
- (707) 547-5471
- NPI assigned
- Mar 2, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Providence Medical Foundation
Practice addresses (Care Compare)
1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210
Hospital & facility affiliations
- Providence Santa Rosa Memorial Hospital
- Providence St Joseph Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161003000441 | CA | Practitioner - Nurse Practitioner | 5193033553 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9371 | CA | MD | Speech-Language Assistant |
| 270798 | CA | MD | Adult Health Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current |
Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current |
Accepting new patients |
Locations
200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805
500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842
1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300
1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Clinical Nurse Specialist | 364SA2200X | 270798 | CA | |
| Adult Health Nurse Practitioner | 363LA2200X | 270798 | CA | Yes |
Addresses
Primary practice location
1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Mailing address
4729A Hoen Ave
Santa Rosa, CA 95405-7862
Phone (707) 577-7800
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | TraumaSurgeryAnnadel@sjhhandhmg.allscriptsdirect.net |
Other providers in Santa Rosa, CA
- Alchemical Counseling Services Licensed Clinical Social Worker, Inc
- John W. Alchemy
- Justine Alcocer
- Marisa Louise Aldaco
- Aldea, Inc.
- Brijida Christina Aleman
- Daniel Alexander
- Egle Alexander
- James Patrick Alexander
- Fani Alexandrakis
All providers in Santa Rosa, CA · Adult Health Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.