1457859258 NPI number — KATHRYN MARIE GILSON OTR/L, IBCLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457859258 NPI number — KATHRYN MARIE GILSON OTR/L, IBCLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GILSON
Provider First Name:
KATHRYN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OTR/L, IBCLC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PETERSON
Provider Other First Name:
KATHRYN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457859258
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
166 GEARY ST.
Provider Second Line Business Mailing Address:
STE 1500 #2152
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94108-5628
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
166 GEARY ST.
Provider Second Line Business Practice Location Address:
STE 1500 #2152
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94108-5628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-319-2742
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/26/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174N00000X , with the licence number:  L-317029 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: 15570 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 15570 . This is a "CALIFORNIA BOARD OF OCCUPATIONAL THERAPY" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: L-317029 . This is a "INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS" identifier . This identifiers is of the category "OTHER".




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