Provider Demographics
NPI:1134867369
Name:DOBBS, KEVIN ANDREW (DNP/FNP)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ANDREW
Last Name:DOBBS
Suffix:
Gender:M
Credentials:DNP/FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 BODIE AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-4812
Mailing Address - Country:US
Mailing Address - Phone:818-294-0627
Mailing Address - Fax:
Practice Address - Street 1:187 E WILBUR RD STE 100
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-7925
Practice Address - Country:US
Practice Address - Phone:805-492-1015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021072363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care