Juanita Tricia Louis, MPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA61178 Issued in CA

Practice address

5730 Packard Ave
Marysville, CA 95901-7118

Phone

(530) 749-3242

Fax

(530) 749-3248

NPI assigned

Jan 10, 2011

Last updated

Sep 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: juanita.louis.p1@direct.peachtreehealth.nextgenshare.com

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.

• Peach Tree Healthcare

  dba Peach Tree Clinic

  • Federally Qualified Health Center (FQHC)
  • Marysville, CA
  • NPI 1003863622
  Medicare reassignment
• Peach Tree Healthcare

  dba Peach Tree Mobile Unit

  • Federally Qualified Health Center (FQHC)
  • Marysville, CA
  • NPI 1669152120
  NPD

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1326342072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 MARSH DR",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959018209",
            "telephone_number": "347-528-9043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 PACKARD AVE",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959017118",
            "telephone_number": "530-749-3242",
            "fax_number": "530-749-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIS",
        "first_name": "JUANITA",
        "middle_name": "TRICIA",
        "credential": "MPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "012291",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA61178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NPI",
            "affiliation": "N",
            "endpointDescription": "NPI",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5730 Packard Ave",
            "city": "Marysville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "959017118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Juan Antonio Lopez Jr.
• Leslie Lopez
• Mario Lopez
• Natalie Lopez, PA-C
• Sreynoch Lor
• Bethany Louque, NP-C
• Ariana Raquel Lozano, LMFT
• Corinna Luddington
• Gordon Andrew Macbeth, M.D.
• Jason Macgregor, EMT-B

• Medical Physician Assistant in Marysville, CA
• Providers in Marysville, 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 Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.