Provider Demographics
NPI:1013034230
Name:WITOWSKA, BARBARA (MS PAC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:WITOWSKA
Suffix:
Gender:F
Credentials:MS PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22032 EL PASEO STE 130
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-3947
Mailing Address - Country:US
Mailing Address - Phone:949-589-9112
Mailing Address - Fax:949-589-9338
Practice Address - Street 1:22032 EL PASEO STE 130
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-3947
Practice Address - Country:US
Practice Address - Phone:949-589-9112
Practice Address - Fax:949-589-9338
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17153363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical