Healthcare Provider Details

I. General information

NPI: 1952014649
Provider Name (Legal Business Name): ISABEL CONTRERAS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2022
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1079 MOANALUA RD STE 630
AIEA HI
96701-4721
US

IV. Provider business mailing address

45 COUNTRY MANOR DR
FREDERICKSBURG VA
22406-7278
US

V. Phone/Fax

Practice location:
  • Phone: 808-485-5414
  • Fax:
Mailing address:
  • Phone: 540-498-8822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberAMD-1469-0
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: