Provider Demographics
NPI:1548833049
Name:SITARSKI, KENDALL RENEE (PA)
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:RENEE
Last Name:SITARSKI
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1730
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1058
Mailing Address - Country:US
Mailing Address - Phone:760-766-1249
Mailing Address - Fax:760-837-2202
Practice Address - Street 1:39000 BOB HOPE DR, HARRY & DIANE RINKER BLG
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3202
Practice Address - Country:US
Practice Address - Phone:760-568-2684
Practice Address - Fax:760-341-5832
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2024-08-23
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical