Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. GLENNISE DANEEN PRATT, PA-C
Active Sole ProprietorPhysician Assistant · WILDOMAR, CA
Registration Details
- NPI Number
- 1447544630
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 5, 2011 (14.911972379626 yrs)
- Last Updated
- Feb 11, 2016
- License
-
PA21581 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
36320 INLAND VALLEY DRIVE307WILDOMAR, CA, 925959083Browse CA providers · Browse ZIP 92595
- Phone
- 9516000110
- Fax
- 9516001489
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in WILDOMAR, CA
| Name | Credential | NPI |
|---|---|---|
| JULIE MARIE SHRYOCK ELIAS | P.A. | 1194768663 |
| MICHAEL A DAVALOS | PA, MS | 1285641902 |
| LISA M BORNMANN | P.A.-C | 1083729891 |
| JOSEPH S DEMATTIA | P.A.-C | 1265547087 |
| PAUL K GROVER | P.A.-C | 1104931872 |
| RICKY A OLDENBURG | PA-C | 1598849374 |
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.