Provider Demographics
NPI:1073797395
Name:MERRELL, VICTORIA ANN (PA)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:ANN
Last Name:MERRELL
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Gender:
Credentials:PA
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Mailing Address - Street 1:345 SAXONY RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2787
Mailing Address - Country:US
Mailing Address - Phone:760-753-7374
Mailing Address - Fax:760-753-0110
Practice Address - Street 1:345 SAXONY RD STE 105
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2787
Practice Address - Country:US
Practice Address - Phone:760-753-7374
Practice Address - Fax:760-753-0110
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2025-02-20
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Provider Licenses
StateLicense IDTaxonomies
IDPA-716363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical