Provider Demographics
NPI:1891391074
Name:TEMPELIS, ERINN COURTENEY (PA-C)
Entity Type:Individual
Prefix:
First Name:ERINN
Middle Name:COURTENEY
Last Name:TEMPELIS
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 1:5270 CARMENTO DR
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-4801
Mailing Address - Country:US
Mailing Address - Phone:818-634-8090
Mailing Address - Fax:
Practice Address - Street 1:701 N WENDY DR
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-3066
Practice Address - Country:US
Practice Address - Phone:805-375-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA58960363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant