Michele Dernay, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA11797 Issued in CA

Practice address

2702 Low CT
Fairfield, CA 94534-9771

Phone

(707) 432-2625

Fax

(707) 432-2622

NPI assigned

May 24, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1336432384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 LOW CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945349771",
            "telephone_number": "707-432-2625",
            "fax_number": "707-432-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERNAY",
        "first_name": "MICHELE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA11797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalpana Deo
• Elizabeth Deol, LCSW
• Navneet Deol, DO
• Jasmine Grace Der
• Anna B Derdzinska, MD
• Srbui Sabrina Dertsakyan, M.A., PSY.D.
• Simon Desmarais-Zalob, LCSW
• Mia Kimiko Desoto
• Emily Detoro
• Amanda Devane, PHD

• Medical Physician Assistant in Fairfield, CA
• Providers in Fairfield, 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 Jul 27, 2015; 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.