CHERYL KETELSEN (NPI# 1770938532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770938532 |
| Entity Type | Individual |
| Full Name | CHERYL KETELSEN |
| Practice Address |
15 Santa Rosa St San Luis Obispo CA 93405-1811 |
| Practice Telephone | 8055412650 |
| Practice Fax Number | 8055414043 |
| Mailing Telephone | 8055412650 |
| Mailing Fax Number | 8055414043 |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2017-04-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
53363 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
15 SANTA ROSA ST |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93405-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265407852 | Robert Jeffrey Herten | Dermatology | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2006-02-17 |
| 1265616361 | Jennifer Remington | Dermatology | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2007-12-26 |
| 1518923432 | Michael P Heffernan | Dermatology | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2006-04-21 |
| 1568431500 | San Luis Dermatology & Laser Clinic Inc | Dermatology | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164076626 | Hilary Abbott Anderson | Physician Assistant | 127 Casa St., San Luis Obispo, CA 93405 | 2019-08-01 |
| 1811465834 | Fatemeh Ladan Ahmadinia | Dentist | 764 N Santa Rosa St, San Luis Obispo, CA 93405 | 2018-11-07 |
| 1538559794 | Arnold Martin Horwitz | Marriage & Family Therapist | 1605 Garnette Drive, San Luis Obispo, CA 93405 | 2015-01-27 |
| 1750794764 | Solmaz Naghsh | Pharmacist | 765 Foothill Blvd, San Luis Obispo, CA 93405 | 2014-06-06 |
| 1609293471 | Robert S. Flores Dmd, Inc | Dentist | 878 Boysen Avenue, San Luis Obispo, CA 93405 | 2014-03-18 |
| 1457776445 | Laura Anne Wilvert | Marriage & Family Therapist | 793 E. Foothill Blvd, Suite A, #278, San Luis Obispo, CA 93405 | 2014-02-27 |
| 1497181200 | Tracey Ruby Madrigal | Counselor | 1106 Oceanaire Dr. #25, San Luis Obispo, CA 93405 | 2013-09-25 |
| 1437597572 | Sarah Michelle Brenis | Counselor | 524 Princeton Place, San Luis Obispo, CA 93405 | 2013-06-11 |
| 1013350974 | Jenna Rose Ramos | Counselor | 1459 Descanso St., San Luis Obispo, CA 93405 | 2013-04-10 |
| 1700140696 | Christopher Dieterich Marchand | Social Worker | 793a E. Foothill Blvd, 190, San Luis Obispo, CA 93405 | 2012-06-26 |
| Find all providers in zip 93405 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053777342 | Kellie Acosta | Physician Assistant | 275 N Chorro St, Apt E, San Luis Obispo, CA 93405-3320 | 2016-01-03 |
| 1942646393 | Shermin Yaghoubi Rutherford | Physician Assistant | 35 Casa St Ste 370, San Luis Obispo, CA 93405-5835 | 2013-05-13 |
| 1235613191 | Claudia Franke | Physician Assistant | 1304 Ella St Ste A, San Luis Obispo, CA 93401-4165 | 2018-09-17 |
| 1134584014 | Justin Schmidt | Physician Assistant | 1428 Phillips Ln Ste 203, San Luis Obispo, CA 93401 | 2015-12-21 |
| 1508020462 | Elizabeth Ann Spears | Physician Assistant | 1551 Bishop St, Suite 220, San Luis Obispo, CA 93401-4635 | 2008-07-10 |
| 1508064593 | Katherine Jane Berman | Physician Assistant | 283 Madonna Rd, San Luis Obispo, CA 93405-5432 | 2007-07-11 |
| 1114128956 | Carolyn Ann Smith | Physician Assistant | 1551 Bishop St, 220, San Luis Obispo, CA 93401-4635 | 2007-05-30 |
| 1134330756 | David Sanford Levy | Physician Assistant | 10 Santa Rosa St, Ste. 201, San Luis Obispo, CA 93405-5825 | 2007-05-25 |
| 1306975743 | Bonnie Heikes | Physician Assistant | 705 Grand Ave, San Luis Obispo, CA 93401-2639 | 2007-03-03 |
| 1467596676 | Michelle Corina Cordova | Physician Assistant | 1551 Bishop St Ste 230, San Luis Obispo, CA 93401-4661 | 2007-02-19 |
| Find all providers in SAN LUIS OBISPO | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93405 |
Please comment or provide details below to improve the information on CHERYL KETELSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.