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General NPI Number Information
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NPI Number | 1487387924
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Entity Type | Individual
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Provider Name | KAITLIN PRECHTL
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Gender | Female
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 15107 VANOWEN ST
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City | VAN NUYS
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State | CA
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Zip | 91405-4542
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Country | US
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Telephone | 818-606-3889
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Fax |
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Provider Business Mailing Address
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Address Line | 1264 DUBONNET CT
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City | OAK PARK
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State | CA
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Zip | 91377-4707
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA62809
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License Number State | CA
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