Provider Demographics
NPI:1083876072
Name:WAAK, NAOMI SUSANNE (PA)
Entity Type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:SUSANNE
Last Name:WAAK
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Gender:F
Credentials:PA
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Mailing Address - Street 1:7619 MORRO RD
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4433
Mailing Address - Country:US
Mailing Address - Phone:805-461-7144
Mailing Address - Fax:805-461-7141
Practice Address - Street 1:5905 CAPISTRANO AVE
Practice Address - Street 2:#C
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-7219
Practice Address - Country:US
Practice Address - Phone:805-461-7144
Practice Address - Fax:805-461-7141
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2023-09-07
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant