Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miss. Mallory Katherine Willenborg, PA-C

Individual provider Physician Assistant · NPI 1598213886

Miss. Mallory Katherine Willenborg, PA-C is a Physician Assistant in Colton, California. Licensed in California and Florida. Registered with an NPI since 2016.

Licensed in
CA, FL
In the registry since
2016
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

400 N Pepper Ave
Colton, CA 92324-1801
Phone: (909) 580-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 53867 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 9109799 (FL)

Record details

NPI number1598213886
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 14, 2016
Last updated in NPPESDecember 10, 2016

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