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NPI Code Detail

MEDICARE: KRISTEN REINCKE MOTLEY PA

MEDICARE: KRISTEN REINCKE MOTLEY PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant51683CA
2363A00000XPhysician AssistantPA200001887DC

General Provider Information

NPI Number : 1740695634
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN REINCKE MOTLEY PA
Provider Business Mailing Address
First Line : 2401 E ST NW SA-1, SUITE L301
Second Line :
City : WASHINGTON
State : DC
Zip : 20522-0001
Country : US
Telephone Number : 202-663-1542
Fax Number :
Provider Business Practice Location Address
First Line : 4279 TIERRA REJADA RD
Second Line :
City : MOORPARK
State : CA
Zip : 93021-3775
Country : US
Telephone Number : 805-222-2323
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2014
Last Update Date : 08/14/2025

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Directions to “ KRISTEN REINCKE MOTLEY PA” Practice Location

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