Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
PEGGY JANE DEFOREST, P.A.
ActivePEGGY JANE DEFOREST, P.A. is a Physician Assistant healthcare provider located in SHASTA LAKE, California. NPI 1447460522 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · SHASTA LAKE, CA
Registration Details
- NPI Number
- 1447460522
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 23, 2007 (19.206661355029 yrs)
- Last Updated
- Jul 8, 2007
- License
-
PA 10739 (CA)
Practice Information
- Address
-
5145 SHASTA DAM BLVDSHASTA LAKE, CA, 960199403Browse CA providers · Browse ZIP 96019
- Phone
- 5302755421
- Primary Specialty
-
Physician Assistant
363A00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.