Provider Demographics
NPI:1083242499
Name:DIPINTO, CAITLYN (PA-C)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:DIPINTO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:
Other - Last Name:KLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3008
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93457-3008
Mailing Address - Country:US
Mailing Address - Phone:951-775-5013
Mailing Address - Fax:
Practice Address - Street 1:10 SANTA ROSA ST # 201
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-5826
Practice Address - Country:US
Practice Address - Phone:951-775-5013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical