MEDICARE: KAITLIN WILLIAMS PA-C

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
1	207N00000X	Dermatology Physician	63623	CA
2	363A00000X	Physician Assistant	63623	CA

General Provider Information

NPI Number	:	1710612411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLIN WILLIAMS PA-C

Provider Business Mailing Address
First Line	:	PO BOX 1206
Second Line	:
City	:	GOLETA
State	:	CA
Zip	:	93116-1206
Country	:	US
Telephone Number	:	805-687-5538
Fax Number	:	805-387-5530

Provider Business Practice Location Address
First Line	:	601 E ARRELLAGA ST STE 101
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93103-2275
Country	:	US
Telephone Number	:	805-687-5538
Fax Number	:	805-687-5530

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2022
Last Update Date	:	03/11/2024

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Directions to “ KAITLIN WILLIAMS PA-C” Practice Location

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