Pruitt, Alberta

Pruitt, Alberta is an individual health care provider with primary practice located at 220 S Palisade Dr , Santa Maria CA 93454-8902. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Pruitt, Alberta can be contacted via phone (805) 681-5461.

Contact Information

Primary practice address
220 S Palisade Dr Santa Maria CA 93454-8902
Phone: (805) 681-5461
Fax: (805) 681-5200
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA11049 California

Profile Details

NPI number 1619096609
LBN Legal business name Pruitt, Alberta
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619096609 NPPES
California MEDICAID 00A110490
California Other PA11049

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