Katelyn Passey Pe, N.P.

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

793963 Issued in CA

Practice address

4060 Fourth Ave
Suite 240
San Diego, CA 92103-2116

Phone

(619) 291-2687

Fax

(619) 291-3492

NPI assigned

Jan 14, 2013

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 1

Other names 1

• Katelyn A Passey Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1861739690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 FOURTH AVE",
            "address_2": "SUITE 240",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032116",
            "telephone_number": "619-291-2687",
            "fax_number": "619-291-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 FOURTH AVE",
            "address_2": "SUITE 240",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032116",
            "telephone_number": "619-291-2687",
            "fax_number": "619-291-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PE",
        "first_name": "KATELYN",
        "middle_name": "PASSEY",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "CA",
            "license": "793963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "21263",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "PASSEY",
            "middle_name": "A",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• PB Chiropractic Inc.
• PB Therapeutic Massage
• PB Wellness, LLC
• Eleanor Pe
• Jonathan Pe, PT
• Mark-Rally L Pe, M.D.
• Brandon Jerod Pea, MEDICAL RECORDS SPEC
• Elizabeth Maryrose Peabody
• Peace and Balance Individual and Family Therapy, Inc.
• Peaceful Palliative Care, Inc.

• Adult Health Clinical Nurse Specialist in San Diego, CA
• Providers in San Diego, CA by specialty
• Adult Health Clinical Nurse Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.