Provider Demographics
NPI:1528155496
Name:KAHLER, KAYCEE LEANN (PAC)
Entity type:Individual
Prefix:MRS
First Name:KAYCEE
Middle Name:LEANN
Last Name:KAHLER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MS
Other - First Name:KAYCEE
Other - Middle Name:LEANN
Other - Last Name:HOLGUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:4580 ARENA WAY
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-9312
Mailing Address - Country:US
Mailing Address - Phone:209-535-2916
Mailing Address - Fax:
Practice Address - Street 1:1801 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2706
Practice Address - Country:US
Practice Address - Phone:209-216-3300
Practice Address - Fax:209-216-3301
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA18608363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant