Provider Demographics
NPI:1780605980
Name:HALLINAN, KAREN A
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:HALLINAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:A
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15611 POMERADO RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2437
Mailing Address - Country:US
Mailing Address - Phone:858-675-3100
Mailing Address - Fax:858-618-1523
Practice Address - Street 1:15611 POMERADO RD
Practice Address - Street 2:SUITE 400
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2437
Practice Address - Country:US
Practice Address - Phone:858-675-3100
Practice Address - Fax:858-618-1523
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9849363L00000X
CA510381363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1780605980Medicaid
CANPF9849OtherMEDICAL LICENSE