Provider Demographics
NPI:1417248337
Name:ARRIAGA, PAULA ADRIANA (PA)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:ADRIANA
Last Name:ARRIAGA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:583 LISBON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-3562
Mailing Address - Country:US
Mailing Address - Phone:510-304-4339
Mailing Address - Fax:
Practice Address - Street 1:2645 OCEAN AVE
Practice Address - Street 2:#303
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1633
Practice Address - Country:US
Practice Address - Phone:415-452-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21563363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant