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General NPI Number Information
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NPI Number | 1922589548
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Entity Type | Individual
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Provider Name | JESSY MACKENZIE ARTHURS PA
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Gender | Female
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 892 AEROVISTA PL STE 120
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-8054
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Country | US
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Telephone | 805-544-5567
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1296
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City | TEMPLETON
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State | CA
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Zip | 93465-1296
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Country | US
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Telephone | 805-610-2516
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | PA56033
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License Number State | CA
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 56033
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License Number State | CA
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