Provider Demographics
NPI:1932415072
Name:HIGGINS, NATALIE ROSE (PA-C)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ROSE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5333 MISSION CENTER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1302
Mailing Address - Country:US
Mailing Address - Phone:619-295-3355
Mailing Address - Fax:619-542-1317
Practice Address - Street 1:225 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4212
Practice Address - Country:US
Practice Address - Phone:760-291-6777
Practice Address - Fax:760-291-6967
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21118363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical