Individual
KENIA NICHELLE WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4359 TWEEDY BLVD, SOUTH GATE, CA 90280-6236
(323) 569-6979
(323) 249-4626
Mailing address
4359 TWEEDY BLVD, SOUTH GATE, CA 90280-6236
(323) 569-6979
(323) 249-4626
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA16377
CA
Other
Enumeration date
06/15/2011
Last updated
06/15/2011
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