MEDICARE: JOCELYN LYBARGER 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
1	363A00000X	Physician Assistant	57912	CA

General Provider Information

NPI Number	:	1750793618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOCELYN LYBARGER PA-C

Provider Business Mailing Address
First Line	:	10956 DONNER PASS RD STE 130
Second Line	:
City	:	TRUCKEE
State	:	CA
Zip	:	96161-4860
Country	:	US
Telephone Number	:	530-582-6400
Fax Number	:	530-582-6991

Provider Business Practice Location Address
First Line	:	10956 DONNER PASS RD STE 130
Second Line	:
City	:	TRUCKEE
State	:	CA
Zip	:	96161-4860
Country	:	US
Telephone Number	:	530-582-6400
Fax Number	:	530-582-6991

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2014
Last Update Date	:	10/02/2024

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