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

Individual provider Medical Physician Assistant · NPI 1073816583

Lacee Marie Childers, PA is a Medical Physician Assistant in Riverside, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2010
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4445 Magnolia Ave
Riverside, CA 92501-4135
Phone: (951) 788-3200
Fax: (951) 788-3200
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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 PA21251 (CA)

Record details

NPI number1073816583
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedDecember 6, 2010
Last updated in NPPESSeptember 14, 2013

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