Axtell-Kelly, Caryn Joy

Axtell-Kelly, Caryn Joy is an individual health care provider with primary practice located at 13193 Central Ave Suite 220, Chino CA 91710. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Axtell-Kelly, Caryn Joy can be contacted via phone (909) 591-0843.

Contact Information

Primary practice address
13193 Central Ave Suite 220 Chino CA 91710
Phone: (909) 591-0843
Fax: (909) 591-7226
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA17278 California

Profile Details

NPI number 1700815958
LBN Legal business name Axtell-Kelly, Caryn Joy
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2006
Last updated Mar 7th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700815958 NPPES
California MEDICAID PA17278

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