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General NPI Number Information
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NPI Number | 1366653834
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Entity Type | Individual
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Provider Name | JESSICA LYN HORAZY PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5995 TOPANGA CANYON BLVD
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-3623
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Country | US
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Telephone | 818-888-7009
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Fax | 818-888-7018
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Provider Business Mailing Address
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Address Line | 6031 AGAPANTHUS PL
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-7201
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Country | US
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Telephone | 818-577-3253
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Fax | 818-716-6480
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 18647
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License Number State | CA
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