Provider Demographics
NPI:1679921217
Name:PENNINGTON, KARA HOPE (PA-C, MMS)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:HOPE
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:PA-C, MMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 VIA DE LA VALLE UNIT A
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2483
Mailing Address - Country:US
Mailing Address - Phone:502-262-7669
Mailing Address - Fax:
Practice Address - Street 1:320 SANTA FE DR STE 207
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5140
Practice Address - Country:US
Practice Address - Phone:502-262-7669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53410363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant