Provider Demographics
NPI:1659026367
Name:PIERSON, DAVID JAY (NP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JAY
Last Name:PIERSON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41715 CHIANTI CT
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1687
Mailing Address - Country:US
Mailing Address - Phone:661-992-3188
Mailing Address - Fax:
Practice Address - Street 1:41715 CHIANTI CT
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1687
Practice Address - Country:US
Practice Address - Phone:661-992-3188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95020043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily