Provider Demographics
NPI:1891022448
Name:SCHLOSSER, KERRY ANN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:ANN
Last Name:SCHLOSSER
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 1:16500 VENTURA BLVD
Mailing Address - Street 2:STE. 409
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2011
Mailing Address - Country:US
Mailing Address - Phone:818-905-5277
Mailing Address - Fax:818-783-5406
Practice Address - Street 1:16500 VENTURA BLVD
Practice Address - Street 2:STE. 409
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2011
Practice Address - Country:US
Practice Address - Phone:818-905-5277
Practice Address - Fax:818-783-5406
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17381363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant