Provider Demographics
NPI:1659826733
Name:KEATING, ALISHA JANE (NP)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:JANE
Last Name:KEATING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:JANE
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2929 HEALTH CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2762
Mailing Address - Country:US
Mailing Address - Phone:858-499-2701
Mailing Address - Fax:
Practice Address - Street 1:2929 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2762
Practice Address - Country:US
Practice Address - Phone:858-499-2701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95004729363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner