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Penny Ketchum
Student in an Organized Health Care Education/Training Program in San Luis Obispo, California
NPI 1861112484

Penny Ketchum is a Student in an Organized Health Care Education/Training Program based in Paso Robles, CA. Penny Ketchum practices in San Luis Obispo, CA. The NPI Number for Penny Ketchum is 1861112484 and holds a License No. (California).

The current practice location address for Penny Ketchum is Colony Dr, San Luis Obispo, CA and can be reached out via phone at 805-547-7900.

Location: Colony Dr, San Luis Obispo, CA, 93446-2300
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1861112484
Provider Name
Penny Ketchum
Credential
Provider Entity Type
Individual
Gender
Female
Address
Colony Dr, San Luis Obispo, CA, 93446-2300
Phone Number
805-547-7900
Fax Number
Provider Enumeration Date
09/01/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
Colony Dr
City
San Luis Obispo
State
California
Zip
93409-0001
Phone Number
805-547-7900
Fax Number
person
Provider Business Mailing Address Details
Address
Colony Dr
City
San Luis Obispo
State
California
Zip
93409-0001
Phone Number
805-547-7900
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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