Angela Fisher-Weaver, PA-C
Individual provider Active NPI Physician Assistant · Squaw Valley, CA
NPI 1669780722 · NPPES record last updated Oct 17, 2025
Key facts
- NPI
- 1669780722
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA21144 (CA)
- Practice address
- 35591 E Kings Canyon Rd Ste B
Squaw Valley, CA 93675-9651 - Phone
- (559) 903-7221
- Fax
- (559) 557-4596
- NPI assigned
- Sep 22, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in CA, ID, WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110324000999 | CA | Practitioner - Physician Assistant | 9335322502 | Reassigns benefits to 7 organizations |
| I20170927004077 | ID | Practitioner - Physician Assistant | 9335322502 | Reassigns benefits to 1 organization |
| I20250304000014 | WY | Practitioner - Physician Assistant | 9335322502 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14191875-1206 | UT | MD | Medical Physician Assistant |
| PA-918 | WY | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Current |
Accepting new patients | |
| Cep America, LLC | Current |
Accepting new patients | |
| Pinnacle Emergency Physicians of Bakersfield, a Professional Corp | Current |
Accepting new patients | |
| Cep America LLC | Current |
Accepting new patients | |
| Nes Western Group, a Professional Corporation | Current |
Accepting new patients | |
| Cody Regional Health EMS | Current |
Accepting new patients | |
| North Fresno Emergency Physicians Medical Group | Past | Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777
500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000
1303 E Herndon Ave
Fresno, CA 93720
Phone (559) 449-3000
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886
4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156
400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001
1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152
424 Yellowstone Ave
Ste 120
Cody, WY 82414
Phone (307) 578-2903
424 Yellowstone Ave
Cody, WY 82414
Phone (307) 578-2903
707 Sheridan Ave
Cody, WY 82414
Phone (307) 527-7561
Interoperability endpoints
- angela.fisher-weaver@1077866882859012.direct.elationemr.com
- angela.fisher-weaver.1@25843.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-1513 | ID | |
| Medical Physician Assistant | 363AM0700X | 14191875-1206 | UT | |
| Medical Physician Assistant | 363AM0700X | PA-918 | WY | |
| Physician Assistant | 363A00000X | PA21144 | CA | Yes |
Addresses
Primary practice location
35591 E Kings Canyon Rd Ste B
Squaw Valley, CA 93675-9651
Mailing address
35591 E Kings Canyon Rd Ste B
Squaw Valley, CA 93675-9651
Phone (559) 903-7221
Other providers in Squaw Valley, CA
- Candice Brantley
- Leticia C. Council
- Rebecca Emerita Geddes
- Joseph F Ruda Jr MD (a Medical Corporation )
- Gail Melton
- San Joaquin Prime Care Medical Group Inc
- Melissa Scheidt
All providers in Squaw Valley, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.