MR. KENNETH LEE HARRISON JR. (NPI# 1871670695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871670695 |
| Entity Type | Individual |
| Full Name | MR. KENNETH LEE HARRISON JR. |
| Credential | PA |
| Practice Address |
3177 Ocean View Blvd. Comprehensive Health Center/san Ysidro Health Center San Diego CA 92113 |
| Mailing Address |
3177 Ocean View Blvd Comprehensive Health Center/san Ysidro Health Center San Diego CA 92113 |
| Practice Telephone | 6192319300 |
| Practice Fax Number | 6198581003 |
| Mailing Telephone | 6192319300 |
| Mailing Fax Number | 6198581003 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-03-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA12009 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225270317 | Kenneth D. Harrison | Obstetrics & Gynecology | 3350 Camels Ridge Ln, Colorado Springs, CO 80904-1030 | 2009-04-03 |
| 1649311754 | Kenneth Harrison | Radiology | 201 N Washington St, Kaiser Permanente Falls Church Medical Center, Falls Church, VA 22046-4518 | 2007-02-09 |
| 1104915537 | Kenneth Thomas Harrison | Dentist | 12900 Perris Blvd, Ste 201, Moreno Valley, CA 92553-4135 | 2006-10-12 |
| 1295705713 | Kenneth Michael Harrison | Dentist | 3259 Catlin Ave, Quantico, VA 22134-5109 | 2006-01-26 |
| Street Address |
3177 OCEAN VIEW BLVD. COMPREHENSIVE HEALTH CENTER/SAN YSIDRO HEALTH CENTER |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609305986 | Cynthia Alba | Nutritionist | 1809 National Ave., San Diego, CA 92113 | 2017-06-08 |
| 1184153983 | Jessy Milligan | Counselor | 4125 Alpha Street, San Diego, CA 92113 | 2017-06-06 |
| 1730557406 | Deborah Mary Malloy | Counselor | Jary Barreto, 2865 Logan Avenue, San Diego, CA 92113 | 2015-09-10 |
| 1104220912 | Imhotep Mustaqeem | Counselor | 3336 Steel Street, San Diego, CA 92113 | 2014-10-22 |
| 1831507300 | Olga Vasileva | Student in an Organized Health Care Education/Training Program | 2865 Logan Avenue, San Diego, CA 92113 | 2014-07-29 |
| 1477961951 | Angelica Quezada | Counselor | 32510 Newton Avenue B103, San Diego, CA 92113 | 2014-07-28 |
| 1477986750 | Anita Pena | Licensed Vocational Nurse | 604 Olivewood Ter, San Diego, CA 92113 | 2013-08-09 |
| 1134459399 | Susana Cabada | Technician, Other | 4031 Marine View Ave., San Diego, CA 92113 | 2010-01-11 |
| 1669595609 | Maria Emilia Siller | Registered Nurse | 3177a Oceanview Blvd, San Diego, AL 92113 | 2007-04-06 |
| 1710009691 | Maria Engracia Siordia | Licensed Vocational Nurse | 3177a Ocean View Blvd, San Diego, CA 92113 | 2007-04-04 |
| Find all providers in zip 92113 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083213706 | Courtney Kathryn Hopp | Physician Assistant | 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 | 2020-10-23 |
| 1639776503 | Nathan Tuan Dinh | Physician Assistant | 8296 Via Escalada, San Diego, CA 92129-2223 | 2020-10-05 |
| 1750988671 | Denise Aquino | Physician Assistant | 7322 Mesa College Dr Apt 7, San Diego, CA 92111-4943 | 2020-10-04 |
| 1962009183 | Courtney Krysl | Physician Assistant | 14434 Corte Lampara, San Diego, CA 92129-3818 | 2020-10-01 |
| 1497369284 | Brian Carroll | Physician Assistant | 7242 Melotte St, San Diego, CA 92119-1613 | 2020-08-31 |
| 1871104067 | Satoshi Ikeda | Physician Assistant | 16198 Paseo Del Sur, San Diego, CA 92127-6155 | 2020-08-12 |
| 1760009989 | Lili Tran | Physician Assistant | 8865 Calle Tragar, San Diego, CA 92129-2156 | 2020-07-03 |
| 1245857259 | Kendra Roberta Witt | Physician Assistant | 11396 Poblado Rd, San Diego, CA 92127-1351 | 2020-06-25 |
| 1336766344 | Brandon Scott Johnson | Physician Assistant | 1540 Oliver Ave Apt C, San Diego, CA 92109-5595 | 2020-06-25 |
| 1104441021 | Kira Ann Tellache | Physician Assistant | 4520 Executive Dr Ste 325, San Diego, CA 92121-3087 | 2020-06-16 |
| Find all providers in SAN DIEGO | ||||
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| 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.