MS. MARY KRESHON PA-C
NPI 1114349693
Physician Assistant - Medical in San Diego, CA

Q: What is Mary Kreshon's NPI number?

The NPI number for Mary Kreshon is 1114349693. It was assigned to this individual provider in the NPPES registry on January 17, 2014.

Q: What is Mary Kreshon's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Mary Kreshon was last updated on December 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 17, 2014

6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121(858) 859-1188 Get Directions Write a Review

NPPES record last updated: December 19, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 19, 2022, May 13, 2019, Feb 1, 2019 (3 updates tracked since 2019).

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About Ms. Mary Kreshon Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. MARY KRESHON PA-C (NPI 1114349693) is an individual medical provider in San Diego, California, licensed in California (52673) and active in the NPI registry since January 2014.

NPPES Registry Identity

NPI1114349693

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMS. MARY KRESHONCredential: PA-C

Location Address6195 LUSK BLVD STE 250San Diego, CA 92121-3715

Mailing Address6195 Lusk Blvd Ste 250San Diego, CA 92121-3715 · (858) 859-1188

Phone(858) 859-1188

Sole ProprietorNo

Enumeration DateJanuary 17, 2014

Last NPPES UpdateDecember 19, 20223 updates tracked since enumeration

NPPES CertifiedDecember 19, 2022

✔ NPI 1114349693 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in CA · 52673

Also ListedPhysician AssistantTaxonomy 363A00000X · License 001004757 (NC)

Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License 0010-04757 (NC)

6195 LUSK BLVD STE 250, San Diego, CA 92121

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALEX BOLTON APRN

Nurse Practitioner (Family)