NPI 1497370514 · live from the CMS NPI Registry
Jantima Shannon Becker, PA
Physician Assistant in La Jolla, CA. National Provider Identifier 1497370514, active.
NPI record
| NPI | 1497370514 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 9850 Genesee Ave Ste 320, La Jolla, CA 92037 |
| Practice phone | 858-554-1212 |
| Mailing address | 1060 Crosswater Dr, Reno, NV 89523 |
| Enumerated | June 15, 2020 |
| Last updated | February 7, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.