Kenneth Lee Harrison Jr., PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12009 Issued in CA

Practice address

3177 Ocean View Blvd.
Comprehensive Health Center/San Ysidro Health Center
San Diego, CA 92113

Phone

(619) 231-9300

Fax

(619) 858-1003

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1871670695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3177 OCEAN VIEW BLVD",
            "address_2": "COMPREHENSIVE HEALTH CENTER/SAN YSIDRO HEALTH CENTER",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92113",
            "telephone_number": "619-231-9300",
            "fax_number": "619-858-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3177 OCEAN VIEW BLVD.",
            "address_2": "COMPREHENSIVE HEALTH CENTER/SAN YSIDRO HEALTH CENTER",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92113",
            "telephone_number": "619-231-9300",
            "fax_number": "619-858-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "KENNETH",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Amber Harrison, RN
• Jasiri Harrison Jr.
• Jon D. Harrison, MD
• Jude George Harrison
• Kanosha Harrison
• Lauren Kristen Harrison, AU.D., CNIM
• Meghan Harrison
• Michael James Harrison
• Michelle Honda Harrison
• Nancy Lee Harrison, M.D.

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.