Provider Demographics
NPI:1740530518
Name:PIERRE-LOUIS, KERBY (PA)
Entity type:Individual
Prefix:
First Name:KERBY
Middle Name:
Last Name:PIERRE-LOUIS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 W VENTURA ST
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1876
Mailing Address - Country:US
Mailing Address - Phone:805-524-2000
Mailing Address - Fax:805-524-9601
Practice Address - Street 1:2323 KNOLL DR
Practice Address - Street 2:SUITE 219
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7307
Practice Address - Country:US
Practice Address - Phone:805-677-5181
Practice Address - Fax:805-677-5304
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22357363A00000X
NY015836363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant