Anastasia Marie Anderson, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA17941 Issued in CA

Practice address

2888 Long Beach Blvd
Suite 240
Long Beach, CA 90806-1530

Phone

(562) 595-7696

Fax

(562) 490-3846

NPI assigned

Jun 8, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1275574709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2888 LONG BEACH BLVD",
            "address_2": "SUITE 240",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061530",
            "telephone_number": "562-595-7696",
            "fax_number": "562-490-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 LONG BEACH BLVD",
            "address_2": "SUITE 240",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061530",
            "telephone_number": "562-595-7696",
            "fax_number": "562-490-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANASTASIA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA17941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ID",
            "identifier": "W19727",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G99710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Camille Andayan
• Sten Daniel Andersen, MD
• Aimee Anderson
• Alyssa Anderson
• Amir Anderson
• Angela Lorraine Anderson, M.S.W.
• Ann Anderson, AMFT
• Arnold Lance Anderson, DDS
• Brandon Anderson
• Brett Anderson

• Surgical Physician Assistant in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.