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NPI Code Detail

MEDICARE: JEANNIN COUNTS PA-C

MEDICARE: JEANNIN COUNTS PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant58129CA
2363A00000XPhysician Assistant9110956FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386147999
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNIN COUNTS PA-C
Provider Business Mailing Address
First Line : 2050 S BLOSSER RD
Second Line :
City : SANTA MARIA
State : CA
Zip : 93458-7310
Country : US
Telephone Number : 805-361-8030
Fax Number : 805-361-8097
Provider Business Practice Location Address
First Line : 2800 RIVERSIDE AVE
Second Line :
City : PASO ROBLES
State : CA
Zip : 93446-1311
Country : US
Telephone Number : 805-238-7250
Fax Number : 805-238-0165
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2018
Last Update Date : 01/27/2026

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1235465774 — ANGELO JULIO CHAVEZ GUERRERO M.D.
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Directions to “ JEANNIN COUNTS PA-C” Practice Location

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