Individual
KIMBERLY KAKITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10238 E HAMPTON AVE STE 406, MESA, AZ 85209-3319
(480) 977-1320
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
57878
CA
363A00000X
Physician Assistant
Primary
7409
AZ
363A00000X
Physician Assistant
PA1244
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528213840
—
NV
Enumeration date
12/01/2008
Last updated
05/18/2023
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