Individual provider Active NPI

Jason Justin, PA-C

  • Physician Assistant
  • Mill Valley, CA
National Provider Identifier
1265967079
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA54845 Issued in CA
Practice address
750 Redwood Hwy Frontage Rd Ste 1204
Mill Valley, CA 94941-2483
Phone
(415) 384-4778
NPI assigned
Apr 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA54845 CA
Physician Assistant 363A00000X PA54845 CA Primary

Addresses

Primary practice location

750 Redwood Hwy Frontage Rd Ste 1204
Mill Valley, CA 94941-2483

Mailing address

434 S San Vicente Blvd # 100
Los Angeles, CA 90048-4108

Other practice location 1

34 Mark West Springs Rd
Santa Rosa, CA 95403-1766
Phone (707) 546-1922

Other practice location 2

434 S San Vicente Blvd # 100
Los Angeles, CA 90048-4108
Phone (310) 360-6780

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
I20180831002301 CA Practitioner - Physician Assistant 9436409067 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UCSF Health Medical FoundationGroup PAC ID 9436239878, 65 clinicians

Practice addresses (Care Compare)

1221 N Dutton Ave
Santa Rosa, CA 95401-4607
Phone (707) 543-8360

170 Columbus Ave
Suite 110
San Francisco, CA 94133-5160
Phone (415) 965-8050

199 W Portal Ave
San Francisco, CA 94127-1305
Phone (415) 821-8798

2395 Lombard St
San Francisco, CA 94123-2601
Phone (415) 796-2242

325 Gellert Blvd
Daly City, CA 94015-2613
Phone (650) 270-2394

6174 State Farm Dr
Rohnert Park, CA 94928-2135
Phone (707) 586-4320

747 52ND St
Oakland, CA 94609-1809
Phone (510) 428-3000

750 Redwood Hwy Frontage Rd
Suite 1204
Mill Valley, CA 94941-2483
Phone (415) 384-4778

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA54845CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Orthopaedic Medical Group, Inc. CurrentSince Nov 9, 2021 Accepting new patients
American Current Care of California, a Medical Corporation CurrentSince Feb 4, 2020 Accepting new patients
Santa Rosa Orthopaedic Medical Group, Inc. CurrentSince Nov 9, 2021 Accepting new patients
Permanente Medical Group Inc CurrentSince Jul 10, 2018 Accepting new patients
American Current Care of California, a Medical Corporation CurrentSince Feb 4, 2020 Accepting new patients
American Current Care of California, a Medical Corporation Past Accepting new patients

Locations

1800 Westwind Dr
Ste 301
Bakersfield, CA 93301
Phone (661) 327-9617

2555 S East Ave
Fresno, CA 93706
Phone (559) 499-2400

1340 Mitchell Rd
Modesto, CA 95351
Phone (209) 581-9711

25115 Madison Ave
Murrieta, CA 92562
Phone (951) 600-9070

1101 S Milliken Ave
Ste C
Ontario, CA 91761
Phone (909) 390-2799

1851 Lombard St
Ste 100
Oxnard, CA 93030
Phone (805) 983-2234

640 S Placentia Ave
Placentia, CA 92870
Phone (714) 579-7772

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

6174 State Farm Dr
Rohnert Park, CA 94928
Phone (707) 586-4320

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

2 Connecticut St
San Francisco, CA 94107
Phone (415) 621-5055

2587 Merced St
San Leandro, CA 94577
Phone (510) 351-3553

740 Nordahl Rd
Ste 131
San Marcos, CA 92069
Phone (760) 432-9000

988 Walsh Ave
Santa Clara, CA 95050
Phone (408) 988-6868

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

1405 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 546-1922

1221 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 543-8360

3 S Linden Ave
South San Francisco, CA 94080
Phone (650) 238-1500

3663 Arch Rd
Ste 400
Stockton, CA 95215
Phone (209) 943-2202

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

21081 S Western Ave
Ste 150
Torrance, CA 90501
Phone (310) 782-3333

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

3680 Industrial Blvd
Ste 550H
West Sacramento, CA 95691
Phone (916) 373-7575

Interoperability endpoints

  • Direct secure messaging: jjustin340937@direct-ucsfmedicalcenter.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1493424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1265967079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 S SAN VICENTE BLVD # 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 REDWOOD HWY FRONTAGE RD STE 1204",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412483",
            "telephone_number": "415-384-4778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Mark West Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954031766",
            "country_code": "US",
            "telephone_number": "707-546-1922",
            "fax_number": "707-569-8620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "434 S San Vicente Blvd # 100",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900484108",
            "country_code": "US",
            "telephone_number": "310-360-6780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUSTIN",
        "first_name": "JASON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-29",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA54845",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA54845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

Verify at the official NPI Registry.