Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Katarina Rosari Soewono, MD

Individual provider Family Medicine Physician · NPI 1366062408

Katarina Rosari Soewono, MD is a Family Practice in Fresno, California. Qualified in 2018, 8 years ago. Practices with Saint Agnes Medical Foundation, a 162-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
8
Licensed in
CA
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4770 W Herndon Ave Ste 110
Fresno, CA 93722-8401
Phone: (559) 450-0463
Fax: (559) 450-0464
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1313 E Herndon Ave Ste 105, Fresno, CA 93720-3306 — (559) 450-4637

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A183157 (CA)

Record details

NPI number1366062408
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 18, 2020
Last updated in NPPESJune 28, 2023
Certification dateJune 28, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Saint Agnes Medical Foundation — 162 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

Other providers in Fresno