Individual provider Active NPI

Diana Garcia, PA-C

  • Physician Assistant
  • Ukiah, CA
National Provider Identifier
1447668918
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
51784 Issued in CA
Practice address
275 S Orchard Ave
Ukiah, CA 95482-5016
Phone
(707) 463-3440
Fax
(707) 463-3446
NPI assigned
Jul 29, 2014
Last updated
Jul 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 51784 CA Primary

Addresses

Primary practice location

275 S Orchard Ave
Ukiah, CA 95482-5016

Mailing address

275 S Orchard Ave
Ukiah, CA 95482-5016
Phone (707) 463-3440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20210127001673 WA Practitioner - Physician Assistant 1658699558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 NE Mother Joseph PL
Vancouver, WA 98664-3200
Phone (360) 514-3727

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51784CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians, PLLC CurrentSince Feb 1, 2023 Accepting new patients
Peacehealth Past Accepting new patients
Pacific Redwood Medical Services Physician Assistant Past Accepting new patients
Dialysis Clinic Inc Past Accepting new patients

Locations

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1447668918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 S ORCHARD AVE",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825016",
            "telephone_number": "707-463-3440",
            "fax_number": "707-463-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 S ORCHARD AVE",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825016",
            "telephone_number": "707-463-3440",
            "fax_number": "707-463-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "DIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-29",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

Verify at the official NPI Registry.