Provider Demographics
NPI:1366653834
Name:HORAZY, JESSICA LYN (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYN
Last Name:HORAZY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6031 AGAPANTHUS PL
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-7201
Mailing Address - Country:US
Mailing Address - Phone:818-577-3253
Mailing Address - Fax:818-716-6480
Practice Address - Street 1:5995 TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-3623
Practice Address - Country:US
Practice Address - Phone:818-888-7009
Practice Address - Fax:818-888-7018
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA18647363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant