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NPI Code Detail

MEDICARE: KATHRYN JEAN VEYNA NP

MEDICARE: KATHRYN JEAN VEYNA NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN495632CA
2363A00000XPhysician AssistantPA17233CA
3363LF0000XFamily Nurse PractitionerNP14520CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA17233OTHERCADCA- PA LICENSE
214520OTHERCANP FURNISHING NUMBER
3RN495632OTHERCALICENSE NUMBER

General Provider Information

NPI Number : 1255374690
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN JEAN VEYNA NP
Provider Business Mailing Address
First Line : 1400 E. CHURCH STREET
Second Line : ATTENTION- MEDICAL STAFF OFFICE
City : SANTA MARIA
State : CA
Zip : 93454
Country : US
Telephone Number : 805-739-3954
Fax Number :
Provider Business Practice Location Address
First Line : 1304 ELLA ST STE A
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4165
Country : US
Telephone Number : 805-549-9555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 12/20/2019

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