Provider Demographics
NPI:1962170480
Name:HENIGE, ARYN (PA-C)
Entity type:Individual
Prefix:
First Name:ARYN
Middle Name:
Last Name:HENIGE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 SKY MESA RD
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-2963
Mailing Address - Country:US
Mailing Address - Phone:619-971-8697
Mailing Address - Fax:
Practice Address - Street 1:2020 SANTA MONICA BLVD STE 400
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2139
Practice Address - Country:US
Practice Address - Phone:310-829-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-09-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant