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General NPI Number Information
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NPI Number | 1518486133
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Entity Type | Individual
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Provider Name | COURTNEY PAXSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/14/2017
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 1992 OLD MISSION DR STE 140
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City | SOLVANG
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State | CA
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Zip | 93463-2302
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Country | US
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Telephone | 805-614-5690
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Fax | 805-614-5691
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Provider Business Mailing Address
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Address Line | 1414 E MAIN ST STE 201
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City | SANTA MARIA
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State | CA
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Zip | 93454-4890
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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 | 54826
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License Number State | CA
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