Provider Demographics
NPI:1346526373
Name:SCHUKART, TINA ROSE (PA-C)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:ROSE
Last Name:SCHUKART
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:UCSB STUDENT HEALTH SERVICES BUILDING 588, M/C 7002
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93106-0001
Mailing Address - Country:US
Mailing Address - Phone:805-893-5339
Mailing Address - Fax:
Practice Address - Street 1:UCSB STUDENT HEALTH SERVICES BUILDING 588, M/C 7002
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-4310
Practice Address - Country:US
Practice Address - Phone:805-893-5339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21905363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant