Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Cheryl Ketelsen

Individual provider Medical Physician Assistant · NPI 1770938532

Cheryl Ketelsen is a Physician Assistant in San Luis Obispo, California. Qualified in 2015, 11 years ago. Practices with San Luis Dermatology, Inc, a 6-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
11
Licensed in
CA
In the registry since
2016
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Practice location Address checks out

15 Santa Rosa St
San Luis Obispo, CA 93405-1811
Phone: (805) 541-2650
Fax: (805) 541-4043
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 53363 (CA)

Record details

NPI number1770938532
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 29, 2016
Last updated in NPPESApril 20, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice San Luis Dermatology, Inc. — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in San Luis Obispo