Individual provider Active NPI

Katherine Khatsenko Gaddini, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Oceanside, CA
National Provider Identifier
1407406200
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95012401 Issued in CA
Practice address
3142 Vista Way Ste 401
Oceanside, CA 92056-3619
Phone
(760) 681-5222
NPI assigned
Sep 13, 2019
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95012401 CA Primary

Addresses

Primary practice location

3142 Vista Way Ste 401
Oceanside, CA 92056-3619

Mailing address

3142 Vista Way Ste 401
Oceanside, CA 92056-3619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95012401CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wpohs a Medical Corporation PastSince Sep 15, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: katherine.khatsenko@3856.securemail.prognocis.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1407406200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3142 VISTA WAY STE 401",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920563619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 VISTA WAY STE 401",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920563619",
            "telephone_number": "760-681-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDINI",
        "first_name": "KATHERINE",
        "middle_name": "KHATSENKO",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95012401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.