Provider Demographics
NPI:1831411453
Name:HARDIN, MEGAN JOHNSTONE (MPA, PA-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:JOHNSTONE
Last Name:HARDIN
Suffix:
Gender:F
Credentials:MPA, PA-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ANN
Other - Last Name:JOHNSTONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPA, PA-C
Mailing Address - Street 1:1479 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2986
Mailing Address - Country:US
Mailing Address - Phone:925-932-9389
Mailing Address - Fax:925-256-9066
Practice Address - Street 1:1479 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE 209
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2986
Practice Address - Country:US
Practice Address - Phone:925-932-9389
Practice Address - Fax:925-256-9066
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20855363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant