Provider Demographics
NPI:1790855369
Name:CLASSEN, CARINA AUDREY (CPNP)
Entity Type:Individual
Prefix:
First Name:CARINA
Middle Name:AUDREY
Last Name:CLASSEN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:915 N MILPAS ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2331
Mailing Address - Country:US
Mailing Address - Phone:805-617-7850
Mailing Address - Fax:805-963-8880
Practice Address - Street 1:915 N MILPAS ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-2331
Practice Address - Country:US
Practice Address - Phone:805-617-7850
Practice Address - Fax:805-963-8880
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVAPN001094363LP0200X
OR200350099NP363LP0200X
CANP12049363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics