Jose C Pesqueda, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

60664 Issued in CA

Practice address

4723 W Main St Ste H
Guadalupe, CA 93434-1787

Phone

(805) 343-5577

Fax

(805) 343-5578

NPI assigned

Jan 26, 2022

Last updated

Dec 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jose.pesqueda.1@17363.direct.athenahealth.com

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.

• Athar M. Ansari M D Inc.

  • Cardiovascular Disease Physician
  • El Centro, CA
  • NPI 1346433059
  Medicare reassignment
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Oceano, CA
  • NPI 1336166248
  Medicare reassignment
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • San Luis Obispo, CA
  • NPI 1275553257
  NPD
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Lompoc, CA
  • NPI 1326065103
  NPD
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Santa Maria, CA
  • NPI 1447277355
  NPD
• Community Health Centers of the Central Coast Inc

  dba Community Health Centers Cambria

  • Federally Qualified Health Center (FQHC)
  • Cambria, CA
  • NPI 1881611705
  NPD
• California Heart and Vascular Clinic LLC

  • Ambulatory Surgical Clinic/Center
  • Poway, CA
  • NPI 1144049560
  NPD (past)

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1710639240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8030",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4723 W MAIN ST STE H",
            "city": "GUADALUPE",
            "state": "CA",
            "postal_code": "934341787",
            "telephone_number": "805-343-5577",
            "fax_number": "805-343-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESQUEDA",
        "first_name": "JOSE",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-26",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Vega Martinez
• Yecenia Muniz
• Teresann Nickle, FNP-BC, PMHNP-BC, DN
• Sabrina Ornelas
• Christine Joohee Park, M.D.
• Mireya Eulalia Pina
• Christina Anne Pinto, D.O.
• Bingsheng Qiao
• Antonio Serrano, LCSW
• Social Advocates for Youth - Santa Maria, Inc. (Santa Maria Valley Youth & Family Center)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.