Provider Demographics
NPI:1023872934
Name:ANEW AESTHETICS BY PHYSICIAN ASSISTANTS, INC.
Entity type:Organization
Organization Name:ANEW AESTHETICS BY PHYSICIAN ASSISTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:VALASEK
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:805-409-4236
Mailing Address - Street 1:105 JOYCE WAY
Mailing Address - Street 2:
Mailing Address - City:PISMO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93449-3206
Mailing Address - Country:US
Mailing Address - Phone:214-732-1143
Mailing Address - Fax:
Practice Address - Street 1:2280 SUNSET DR UNIT EEE
Practice Address - Street 2:
Practice Address - City:LOS OSOS
Practice Address - State:CA
Practice Address - Zip Code:93402-4007
Practice Address - Country:US
Practice Address - Phone:805-409-4236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty