Provider Demographics
NPI:1720282718
Name:ESTY, TRESSA MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:TRESSA
Middle Name:MARIE
Last Name:ESTY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TRESSA
Other - Middle Name:MARIE
Other - Last Name:DOTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 N MILLER ST
Mailing Address - Street 2:BUILDING C
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4557
Mailing Address - Country:US
Mailing Address - Phone:805-739-0033
Mailing Address - Fax:
Practice Address - Street 1:120 N MILLER ST
Practice Address - Street 2:BUILDING C
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4557
Practice Address - Country:US
Practice Address - Phone:805-739-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22315363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant