Provider Demographics
NPI:1295255800
Name:PISKLOV, HANNAH SCOBEL (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:SCOBEL
Last Name:PISKLOV
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:ELLEN
Other - Last Name:SCOBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:850 FAIR OAKS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-3929
Mailing Address - Country:US
Mailing Address - Phone:805-473-0700
Mailing Address - Fax:805-473-5931
Practice Address - Street 1:850 FAIR OAKS AVE STE 100
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420
Practice Address - Country:US
Practice Address - Phone:805-473-0700
Practice Address - Fax:805-473-5931
Is Sole Proprietor?:No
Enumeration Date:2017-06-24
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54795363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant