Jacqueline Vasquez

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA62859 Issued in CA

Practice address

1100 W Gonzales Rd
Oxnard, CA 93036-3336

Phone

(805) 988-0053

Fax

(805) 988-0554

NPI assigned

Jul 15, 2022

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

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinicas del Camino Real IncGroup PAC ID 3173434396, 99 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacqueline.vasquez.p1@direct.clinicas.nextgenshare.com
• Direct secure messaging: jvasquez802694@direct.ochin.org

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

• Clinicas del Camino Real Inc

  • Federally Qualified Health Center (FQHC)
  • Ventura, CA
  • NPI 1679631907
  Medicare reassignment Care Compare group
• Clinicas del Camino Real Inc

  • Community Health Clinic/Center
  • Oxnard, CA
  • NPI 1235866138
  NPD
• Clinicas del Camino Real Inc

  • Federally Qualified Health Center (FQHC)
  • Moorpark, CA
  • NPI 1841556404
  NPD
• Clinicas del Camino Real Inc

  • Federally Qualified Health Center (FQHC)
  • Camarillo, CA
  • NPI 1295297190
  NPD (past)

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

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1386378156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W GONZALES RD",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930363336",
            "telephone_number": "805-988-0053",
            "fax_number": "805-988-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-15",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariela Varis, MD
• Anita Vasquez Mendoza, PPS
• Amie Vasquez
• Andre Vasquez, PPS
• Erica Vasquez
• Jazmine E Vasquez, LVN
• Katherine Vasquez
• Kimberly Vasquez, MS, PPS, APCC
• Marie Alexandra Vasquez
• Roxanne Vasquez, MD

• Physician Assistant in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.