Joshua Bennett, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA64095 Issued in CA

Practice address

2450 Craven St BLDG 3300
San Diego, CA 92136-2226

Phone

(619) 881-9202

NPI assigned

Feb 8, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• NMC San Diego

  • Military/U.S. Coast Guard Pharmacy
  • San Diego, CA
  • NPI 1124125984
  NPD
• Oakwood Springs, LLC

  • Psychiatric Hospital
  • Oklahoma City, OK
  • NPI 1770932410
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1093469017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 NW 196TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730123636",
            "telephone_number": "858-245-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 CRAVEN ST BLDG 3300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921362226",
            "telephone_number": "619-881-9202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2232 NW 196th St",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730123636",
            "country_code": "US",
            "telephone_number": "858-245-0998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JOSHUA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-08",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "4748",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4748",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA64095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chase Alan Bennett, DDS
• Crystal Bennett
• Gabrielle Bennett
• Grace Ann Bennett
• Jessica Lynn Bennett, NNP-BC
• Jr Bennett, DMD
• Kevin Bennett, IMF
• Mackenzie Marie Bennett, IIN
• Mark Bennett
• Marlena Mae Bennett, RN

• Medical Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.