Individual provider Active NPI

Courtney Ojeda, PA-C

  • Physician Assistant
  • Sunnyvale, CA
National Provider Identifier
1164267688
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
64686 Issued in CA
Practice address
1620 Kitchener Dr
Sunnyvale, CA 94087-4131
Phone
(805) 931-9544
NPI assigned
Jun 26, 2024
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 64686 CA Primary

Addresses

Primary practice location

1620 Kitchener Dr
Sunnyvale, CA 94087-4131

Mailing address

1620 Kitchener Dr
Sunnyvale, CA 94087-4131
Phone (805) 931-9544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827002016 CA Practitioner - Physician Assistant 5799224358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
San Juan Bautista School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1102 E Clark Ave
Suite 120B
Orcutt, CA 93455-5175
Phone (805) 332-8188

1310 Las Tablas Rd
Suite 103
Templeton, CA 93465-9746
Phone (805) 434-0829

1400 E Church St
Santa Maria, CA 93454-5906
Phone (805) 739-3000

1911 Johnson Ave
San Luis Obispo, CA 93401-4131
Phone (805) 543-5353

525 Plaza Dr
Santa Maria, CA 93454-6953
Phone (805) 739-3848

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
64686CAMDPhysician Assistant

Organizations & group practices 1

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1164267688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 KITCHENER DR",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940874131",
            "telephone_number": "805-931-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 KITCHENER DR",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940874131",
            "telephone_number": "805-931-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJEDA",
        "first_name": "COURTNEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "64686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.