Provider Demographics
NPI:1942378583
Name:FIELDS, KAREN (PA, NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:FIELDS
Suffix:
Gender:F
Credentials:PA, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31343 LONE TREE ROAD
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361
Mailing Address - Country:US
Mailing Address - Phone:209-847-4422
Mailing Address - Fax:
Practice Address - Street 1:VALLEY WOUND HEALING CENTER
Practice Address - Street 2:4335A NSTARWAY
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356
Practice Address - Country:US
Practice Address - Phone:209-342-5125
Practice Address - Fax:209-342-5128
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15798363A00000X
363A00000X
CA11933363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant