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

MS. Mary Kreshon, PA-C

Individual provider Physician Assistant · NPI 1114349693

MS. Mary Kreshon, PA-C is a Physician Assistant in San Diego, California. Licensed in California and North Carolina. Registered with an NPI since 2014.

Licensed in
CA, NC
In the registry since
2014
Specialties on file
3
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

6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Phone: (858) 859-1188
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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 52673 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 001004757 (NC)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 0010-04757 (NC)

Record details

NPI number1114349693
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 17, 2014
Last updated in NPPESDecember 19, 2022
Certification dateDecember 19, 2022

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