Active NPI
Zachary Michael Defouw, PA-C
- Physician Assistant
- Redding, CA
National Provider Identifier
1346048717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA67003
- Practice address
- 415 Knollcrest Dr Ste 101
Redding, CA 96002-0181 - Phone
- (530) 255-7507
- NPI assigned
- Mar 3, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA67003 | CA | Primary |
| Surgical Physician Assistant | 363AS0400X | |||
| Medical Physician Assistant | 363AM0700X |
Addresses
Primary practice location
415 Knollcrest Dr Ste 101
Redding, CA 96002-0181
Mailing address
415 Knollcest Dr Ste 101
Redding, CA 96002
Phone (530) 255-7507
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA67003 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774828800000",
"number": "1346048717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 KNOLLCEST DR STE 101",
"city": "REDDING",
"state": "CA",
"postal_code": "96002",
"telephone_number": "530-255-7507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 KNOLLCREST DR STE 101",
"city": "REDDING",
"state": "CA",
"postal_code": "960020181",
"telephone_number": "530-255-7507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEFOUW",
"first_name": "ZACHARY",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-03-03",
"last_updated": "2026-03-30",
"certification_date": "2026-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA67003",
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.