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Individual

COURTNEY A EASTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1630 E HERNDON AVE, FRESNO, CA 93720-3391
(559) 256-5200
(559) 256-5376
Mailing address
135 CARMEN LN, SANTA MARIA, CA 93458-7729
(806) 928-7361
(805) 928-5742

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
22221
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22221
PHYSICAN ASSISTANT COMMITTEE LICENSE
CA
Enumeration date
05/29/2012
Last updated
05/09/2018
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