Provider Demographics
NPI:1154451664
Name:FRASER, HELENA CULVER (PA-C)
Entity Type:Individual
Prefix:MS
First Name:HELENA
Middle Name:CULVER
Last Name:FRASER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74090 EL PASEO
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-4135
Mailing Address - Country:US
Mailing Address - Phone:760-341-8244
Mailing Address - Fax:760-369-3011
Practice Address - Street 1:7281 DUMOSA AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-3769
Practice Address - Country:US
Practice Address - Phone:760-365-7546
Practice Address - Fax:760-369-3011
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA11455363A00000X, 363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA11455OtherMEDICAL LICENSE
CA0PA114550Medicare ID - Type Unspecified