Provider Demographics
NPI:1073049375
Name:ESPINOZA, KRISTEN AILEEN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:AILEEN
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:KRISTEN
Other - Middle Name:AILEEN
Other - Last Name:KICHLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2115 SHERINGTON PL APT D314
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-6603
Mailing Address - Country:US
Mailing Address - Phone:610-442-4827
Mailing Address - Fax:
Practice Address - Street 1:2115 SHERINGTON PL APT D314
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-6603
Practice Address - Country:US
Practice Address - Phone:610-442-4827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NON-LICENSED363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant