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General NPI Number Information
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NPI Number | 1588776694
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Entity Type | Individual
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Provider Name | KATHERINE A SHELTON P.A.
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/09/2024
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Provider Practice Location Address
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Address Line | 415 N CRESCENT DR STE 320
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-6813
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Country | US
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Telephone | 888-803-3370
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Fax |
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Provider Business Mailing Address
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Address Line | 1391 SKY RIDGE CT
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City | SAN MARCOS
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State | CA
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Zip | 92078-1053
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Country | US
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Telephone | 858-964-8977
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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 | 50.007452RX
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-09096
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA18063
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License Number State | CA
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