Provider Demographics
NPI:1669186581
Name:ARANTOWICZ, KAYLA ALEXIS (PA-C)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:ALEXIS
Last Name:ARANTOWICZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10565 CIVIC CENTER DR STE 250
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3854
Mailing Address - Country:US
Mailing Address - Phone:626-696-1400
Mailing Address - Fax:626-696-1451
Practice Address - Street 1:3434 MIDWAY DR STE 2001
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-4924
Practice Address - Country:US
Practice Address - Phone:619-325-1161
Practice Address - Fax:619-325-1717
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
CA64647363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program