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CARYN JOY AXTELL-KELLY P.A.-C NPI 1700815958


NPI Information

NPI: 1700815958
Provider Name: CARYN JOY AXTELL-KELLY, P.A.-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
13193 CENTRAL AVE
SUITE 220
CHINO, CA
ZIP 91710
Phone: (909) 591-0843
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Caryn Joy Axtell-kelly, P.A.-C is a medical physician assistant in Chino, CA. Caryn Joy Axtell-kelly, P.A.-C NPI is 1700815958. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

13193 CENTRAL AVE
SUITE 220
CHINO, CA
ZIP 91710
Phone: (909) 591-0843
Fax: (909) 591-7226

The NPI 1700815958 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/1/2006 and was last updated on 3/7/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363AM0700XPhysician AssistantMedicalPA17278CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1P00417678MEDICARE PINCALIFORNIA
2PA17278MEDICAIDCALIFORNIA
30PA172780MEDICARE PINCALIFORNIA
40PA172780MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.