Individual provider Active NPI

Ryan Joseph Aragones Honculada

  • Medical Physician Assistant
  • Stockton, CA
National Provider Identifier
1659008662
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA63748 Issued in CA
Practice address
1800 N California St
Stockton, CA 95204-6019
Phone
(209) 467-6560
NPI assigned
Aug 1, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X PA63748 CA Primary

Addresses

Primary practice location

1800 N California St
Stockton, CA 95204-6019

Mailing address

1701 S Mills Ave Apt 11
Lodi, CA 95242-4256
Phone (562) 916-6799

Other practice location 1

11920 164th St
Norwalk, CA 90650-7243
Phone (562) 916-6799

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250707000464 CA Practitioner - Physician Assistant 7214441906 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63748CAMDDentist
PA63748CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Port City Operating Company, LLC Multi-Specialty CurrentSince Apr 24, 2025 Accepting new patients
Port City Operating Company, LLC CurrentSince Apr 24, 2025 Accepting new patients

Locations

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1659008662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 S MILLS AVE APT 11",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424256",
            "telephone_number": "562-916-6799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-467-6560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11920 164th St",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CA",
            "postal_code": "906507243",
            "country_code": "US",
            "telephone_number": "562-916-6799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HONCULADA",
        "first_name": "RYAN JOSEPH",
        "middle_name": "ARAGONES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-01",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA63748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.