Provider Demographics
NPI:1619157831
Name:ESTERS, LATAVIA S (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LATAVIA
Middle Name:S
Last Name:ESTERS
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 1:4278 N BAIN AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-0447
Mailing Address - Country:US
Mailing Address - Phone:559-681-5133
Mailing Address - Fax:
Practice Address - Street 1:135 CARMEN LN
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-7729
Practice Address - Country:US
Practice Address - Phone:805-332-4568
Practice Address - Fax:800-417-9245
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19444363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant