Provider Demographics
NPI:1053933978
Name:CLYMA, EMILY CATHERINE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:CATHERINE
Last Name:CLYMA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:CATHERINE
Other - Last Name:SCROGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2319 VISTA DEL MAR
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94404-2490
Mailing Address - Country:US
Mailing Address - Phone:916-390-6728
Mailing Address - Fax:
Practice Address - Street 1:2725 CAPITOL AVE DEPT 402
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6032
Practice Address - Country:US
Practice Address - Phone:916-262-9404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58092363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical