Provider Demographics
NPI:1134272032
Name:KINCEY, KAREN (PA-C)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:KINCEY
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 1:1463 E 139TH ST
Mailing Address - Street 2:
Mailing Address - City:ROSEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90222-3701
Mailing Address - Country:US
Mailing Address - Phone:310-517-3301
Mailing Address - Fax:310-257-6457
Practice Address - Street 1:25825 S. NORMANDIE AVE.
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90222
Practice Address - Country:US
Practice Address - Phone:310-517-3301
Practice Address - Fax:310-257-6457
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA10692363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical