Individual provider · NPI-1

Kathleen M. Nelson, PA-C

Physician Assistant · Moorpark, CA

NPI number1326229162
StatusActive
Last updated in NPPESJun 15, 2023

Details

NPI
1326229162
Entity type
Individual (NPI-1)
Name
Mrs. Kathleen M. Nelson
Credential
PA-C
Sex
Female
Sole proprietor
No
Enumeration date
Nov 20, 2007
Certification date
Jun 15, 2023
Last updated
Jun 15, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant13766CAYes

Practice location

14711 Princeton Ave
Suite 2
Moorpark, CA 93021-1457

Phone 805-532-2032 · Fax 805-532-2844

Mailing address

14711 Princeton Ave
Suite 2
Moorpark, CA 93021-1457

Phone 805-532-2032 · Fax 805-532-2844

Other practice locations

3525 Loma Vista Rd
Ventura, CA 93003-3100

Phone 805-641-6415

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