Individual provider Active NPI

Catherine Mullin, NP

  • Family Nurse Practitioner
  • San Bruno, CA
National Provider Identifier
1952462780
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
271974 Issued in CA
Practice address
801 Traeger Ave
Suite 212
San Bruno, CA 94066-3048
Phone
(650) 742-7110
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 271974 CA Primary

Addresses

Primary practice location

801 Traeger Ave
Suite 212
San Bruno, CA 94066-3048

Mailing address

1200 El Camino Real
4TH Floor Mob
South San Francisco, CA 94080-3208

Other names 1

  • Catherine Marie Coughlin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040903001030 CA Practitioner - Nurse Practitioner 2365418928 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3581CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Apr 3, 2011 Accepting new patients
Permanente Medical Group Inc CurrentSince Apr 3, 2011 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
John Muir Physician Network Past Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

801 Traeger Ave
Ste 212
San Bruno, CA 94066
Phone (650) 742-5943

1200 El Camino Real
Fl 4
South San Francisco, CA 94080

1200 El Camino Real
South San Francisco, CA 94080
Phone (650) 742-2100

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952462780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 EL CAMINO REAL",
            "address_2": "4TH FLOOR MOB",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 TRAEGER AVE",
            "address_2": "SUITE 212",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663048",
            "telephone_number": "650-742-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "CATHERINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "271974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "COUGHLIN",
            "middle_name": "MARIE",
            "credential": "RN, NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Bruno, CA

Sources for this page

Verify at the official NPI Registry.