Provider Demographics
NPI:1972276756
Name:KLEIN, EMMA KATHERINE (PA-C)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:KATHERINE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:KATHERINE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:607 E PINE AVE
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-3149
Mailing Address - Country:US
Mailing Address - Phone:805-680-9303
Mailing Address - Fax:
Practice Address - Street 1:121 NORTHRIDGE RD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-1925
Practice Address - Country:US
Practice Address - Phone:805-680-9303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant