Provider Demographics
NPI:1215584628
Name:CHATFIELD, ALEXANDRA J (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:J
Last Name:CHATFIELD
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 1:4646 LOTUS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-1724
Mailing Address - Country:US
Mailing Address - Phone:760-524-7863
Mailing Address - Fax:
Practice Address - Street 1:408 W 8TH ST
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-1002
Practice Address - Country:US
Practice Address - Phone:760-524-7863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57107363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant