TANNER PAVELKA NP
NPI 1659233955
Nurse Practitioner - Psychiatric/Mental Health in San Diego, CA

Q: What is Tanner Pavelka's NPI number?

The NPI number for Tanner Pavelka is 1659233955. It was assigned to this individual provider in the NPPES registry on November 25, 2025.

Q: What is Tanner Pavelka's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Tanner Pavelka was last updated on November 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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 November 25, 2025

2425 BLOM ST, SAN DIEGO, CA 92109(704) 689-5482 Get Directions Write a Review

NPPES record last updated: November 25, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Tanner Pavelka Np NPPES

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

TANNER PAVELKA NP (NPI 1659233955) is an individual psychiatric/mental health provider in San Diego, California, licensed in California (95036682) and active in the NPI registry since November 2025.

NPPES Registry Identity

NPI1659233955

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameTANNER PAVELKACredential: NP

Location Address2425 BLOM STSan Diego, CA 92109-3735

Mailing Address2425 Blom StSan Diego, CA 92109-3735

Phone(704) 689-5482

Sole ProprietorYes

Enumeration DateNovember 25, 2025

NPPES CertifiedNovember 25, 2025

✔ NPI 1659233955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95036682

2425 BLOM ST, San Diego, CA 92109

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tanner Pavelka's NPI number?

The NPI number for Tanner Pavelka is 1659233955. It was assigned to this individual provider in the NPPES registry on November 25, 2025.

Where is Tanner Pavelka located?

Tanner Pavelka practices at 2425 Blom St, San Diego, CA 92109. The listed phone number is (704) 689-5482.

What is Tanner Pavelka's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Tanner Pavelka was last updated on November 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.