Provider Demographics
NPI:1134611320
Name:JONES, KAITLIN AMANDA (PA-C)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:AMANDA
Last Name:JONES
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1401 N TUSTIN AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8689
Mailing Address - Country:US
Mailing Address - Phone:714-835-4800
Mailing Address - Fax:
Practice Address - Street 1:363 S MAIN ST STE 485
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3833
Practice Address - Country:US
Practice Address - Phone:714-835-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant