Provider Demographics
NPI:1952176422
Name:GARCIA, KAYLEE ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:ELIZABETH
Last Name:GARCIA
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:KAYLEE
Other - Middle Name:ELIZABETH
Other - Last Name:WARDLOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2710 N HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-1028
Mailing Address - Country:US
Mailing Address - Phone:619-278-7035
Mailing Address - Fax:
Practice Address - Street 1:2710 N HARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-1028
Practice Address - Country:US
Practice Address - Phone:619-278-7035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant