Provider Demographics
NPI:1417223165
Name:TAPIA, JEANNA CASH (PA-C)
Entity type:Individual
Prefix:
First Name:JEANNA
Middle Name:CASH
Last Name:TAPIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JEANNA
Other - Middle Name:LYNN
Other - Last Name:CASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 80397
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92138-0397
Mailing Address - Country:US
Mailing Address - Phone:877-693-2787
Mailing Address - Fax:480-821-3610
Practice Address - Street 1:2452 FENTON ST
Practice Address - Street 2:SUITE C101
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-3599
Practice Address - Country:US
Practice Address - Phone:619-600-5309
Practice Address - Fax:619-655-4700
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5015363AM0700X
CA22882363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical