Healthcare Provider Details

I. General information

NPI: 1487104550
Provider Name (Legal Business Name): KATHRYN KUHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2016
Last Update Date: 12/22/2023
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 CEDAR RD
VISTA CA
92083-5102
US

IV. Provider business mailing address

3210 WILLIAMS GLEN DR
SUGAR LAND TX
77479-2442
US

V. Phone/Fax

Practice location:
  • Phone: 858-927-5527
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number54583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: