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General NPI Number Information
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NPI Number | 1134956816
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Entity Type | Individual
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Provider Name | CASSANDRA KARI FELICIANO
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Gender | Female
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Dates
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Enumeration Date | 09/17/2024
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 29826 HAUN RD STE 314
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City | MENIFEE
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State | CA
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Zip | 92586-6546
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Country | US
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Telephone | 951-381-8150
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Fax |
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Provider Business Mailing Address
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Address Line | 11251 ROSARITA DR
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City | LOMA LINDA
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State | CA
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Zip | 92354-3209
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Country | US
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Telephone | 909-583-1472
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA65329
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License Number State | CA
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