Provider Demographics
NPI:1215209770
Name:HOWELL, SHELLEY NICOLE (PA)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:NICOLE
Last Name:HOWELL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11160 WARNER AVE STE 311
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4055
Mailing Address - Country:US
Mailing Address - Phone:714-850-7300
Mailing Address - Fax:714-850-7310
Practice Address - Street 1:11160 WARNER AVE STE 311
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4055
Practice Address - Country:US
Practice Address - Phone:714-850-7300
Practice Address - Fax:714-850-7310
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22085363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant