Individual provider Active NPI

Lara L. Callahan, RDMS, PA-C

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1700065612
Registry record updated Apr 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
19154 Issued in CA
Practice address
4301 X St
Sacramento, CA 95817-2214
Phone
(800) 282-3284
NPI assigned
Oct 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2026

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 19154 CA Primary

Addresses

Primary practice location

4301 X St
Sacramento, CA 95817-2214

Mailing address

4301 X St
Sacramento, CA 95817-2214
Phone (800) 282-3284

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
I20080501000733 CA Practitioner - Physician Assistant 3274612296 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19154CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Clinic Medical Group Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
La Jolla Radiology Medical Group - Diagnosis, Inc. Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777161600000",
    "number": "1700065612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 X ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172214",
            "telephone_number": "800-282-3284",
            "fax_number": "805-772-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 X ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172214",
            "telephone_number": "800-282-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "LARA",
        "middle_name": "L.",
        "credential": "RDMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-26",
        "last_updated": "2026-04-26",
        "certification_date": "2026-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "19154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.