CARYN JOY AXTELL-KELLY (NPI# 1700815958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700815958 |
| Entity Type | Individual |
| Full Name | CARYN JOY AXTELL-KELLY |
| Credential | P.A.-C |
| Practice Address |
13193 Central Ave Suite 220 Chino CA 91710 |
| Mailing Address |
Po Box 2492 Rancho Cucamonga CA 91729-2492 |
| Practice Telephone | 9095910843 |
| Practice Fax Number | 9095917226 |
| Mailing Telephone | 9095910843 |
| Mailing Fax Number | 9095917226 |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2008-03-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA17278 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | PA17278 | 05 |
| Street Address |
13193 CENTRAL AVE SUITE 220 |
| City | CHINO |
| State | CA |
| Zip Code | 91710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285633867 | James M Lally | Family Medicine | 13193 Central Ave, Ste. 100, Chino, CA 91710-4179 | 2005-07-18 |
| 1730794694 | Adriane Denise Burns | Nurse Practitioner | 13193 Central Ave, Chino, CA 91710-4179 | 2020-09-08 |
| 1043834658 | Hye Kyung Jeon Chase | Registered Nurse | 13193 Central Ave, Chino, CA 91710-4179 | 2020-05-31 |
| 1801307368 | Health Service Alliance | Psychologist | 13193 Central Ave, Chino, CA 91710-4179 | 2017-10-23 |
| 1316353865 | Jason Mathews | Family Medicine | 13193 Central Ave, Chino, CA 91710-4179 | 2014-07-05 |
| 1609296433 | Daniel Park | Family Medicine | 13193 Central Ave, Chino, CA 91710-4179 | 2014-04-20 |
| 1205262466 | Sana Khan | Family Medicine | 13193 Central Ave, Ste 100, Chino, CA 91710-4179 | 2013-09-19 |
| 1134569775 | Janna Kay Brennan-lynch | Registered Nurse | 13193 Central Ave, Suite 220, Chino, CA 91710-4179 | 2013-06-27 |
| 1073869392 | Marcelino Dellopac Latina | Pediatrics | 13193 Central Ave, Suite 100, Chino, CA 91710-4179 | 2012-07-24 |
| 1821373978 | Chino Valley Orthopedic Center Inc | Orthopaedic Surgery | 13193 Central Ave, Suite 100, Chino, CA 91710-4179 | 2011-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962037887 | Corrections and Rehabilitation | Pharmacy | 14901 So Central Avenue, Chino, CA 91710 | 2020-03-11 |
| 1053968289 | California Institute for Men Phcy | Pharmacy | 14901 So Central Ave, Chino, CA 91710 | 2019-08-22 |
| 1982170510 | Kind Care Connections, LLC | In Home Supportive Care | 14726 Ramona Ave # E10, Chino, CA 91710 | 2018-10-22 |
| 1922593789 | Christopher Armando Camarena | Assistant Behavior Analyst | 6062 Eucalyptus Ave, Chino, CA 91710 | 2018-06-25 |
| 1730696519 | Barsoum Dental Corp | Dentist | 14613 Ramona Ave, Chino, CA 91710 | 2018-01-03 |
| 1326569864 | Christina La | Optometrist | 5250 Philadelphia St Ste D, Chino, CA 91710 | 2017-07-06 |
| 1629502554 | Jk Pharmacy Inc | Pharmacy | 5562 Philadelphia St, #110, Chino, CA 91710 | 2017-04-18 |
| 1801336680 | Altek Drugs Inc. | Pharmacy | 13085 Central Ave Ste 2, Chino, CA 91710 | 2017-02-28 |
| 1518405893 | Audrey Ronquillo | Behavior Technician | 800 Ferrari Ln, Suite 100, Ontario, CA 91710 | 2017-02-07 |
| 1952849556 | Jennifer Huynh | Behavior Technician | 800 Ferrari Ln Suite 100, Ontario, CA 91710 | 2017-02-03 |
| Find all providers in zip 91710 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679024426 | Danielle Elisa Martinez | Physician Assistant | 13768 Roswell Ave Ste 115, Chino, CA 91710-1402 | 2016-10-17 |
| 1689860082 | Sean Fitzgerald Coleman | Physician Assistant | 14726 Ramona Ave Ste And107, Chino, CA 91710-5730 | 2007-09-19 |
| 1659563369 | Michael Don Cordia | Physician Assistant | 14726 Ramona Ave Ste 107, Chino, CA 91710-5730 | 2007-08-16 |
| 1356884639 | Adam Elevario | Physician Assistant | 13768 Roswell Ave, Suite 118, Chino, CA 91710-1401 | 2016-11-18 |
| 1952730061 | Heather Michelle Sykes | Physician Assistant | 5475 Walnut Ave, Chino, CA 91710-2609 | 2013-11-08 |
| 1003154428 | Neeru Kaur Gaetano | Physician Assistant | 13768 Roswell Ave, Suite 216, Chino, CA 91710-1401 | 2013-01-18 |
| 1649419482 | Andrew Alfred Harris | Physician Assistant | 5475 Walnut Ave, Chino, CA 91710-2609 | 2009-02-18 |
| 1417080052 | Kristi Jo Diehl | Physician Assistant | 15361 Central Ave, Chino, CA 91710-7608 | 2007-03-13 |
| 1609808468 | Jose Domingo Garcia | Physician Assistant | 11760 Central Ave, Suite 100, Chino, CA 91710-1900 | 2006-07-06 |
| 1194753426 | Stephen Anthony Harvey | Physician Assistant | 5475 Walnut Ave, Chino, CA 91710-2609 | 2006-06-28 |
| Find all providers in CHINO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.