Provider Demographics
NPI:1487604633
Name:TOTTEN, ANISSA LOWERY (PA)
Entity type:Individual
Prefix:MS
First Name:ANISSA
Middle Name:LOWERY
Last Name:TOTTEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ANISSA
Other - Middle Name:L
Other - Last Name:LOWERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1 EMBARCADERO CTR STE 1900
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3723
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:415-252-7176
Practice Address - Street 1:950 BATTERY AVE SE STE 1216
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3094
Practice Address - Country:US
Practice Address - Phone:415-658-6791
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004641363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA504338361DMedicaid
GA504338361BMedicaid
GA504338361CMedicaid
GA504338361CMedicaid
GA504338361DMedicaid