Active NPI
George Allen Anderson, PA
- Physician Assistant
- Sacramento, CA
National Provider Identifier
1720060569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA10774
- Practice address
- 2315 Stockton Blvd
Sacramento, CA 95817-2201 - Phone
- (916) 734-3888
- NPI assigned
- Nov 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA10774 | CA | Primary |
Addresses
Primary practice location
2315 Stockton Blvd
Sacramento, CA 95817-2201
Mailing address
137 Coloma Way
Sacramento, CA 95819-2248
Phone (916) 451-6717
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10774 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| PA10774 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1720060569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 COLOMA WAY",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958192248",
"telephone_number": "916-451-6717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2315 STOCKTON BLVD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172201",
"telephone_number": "916-734-3888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "GEORGE",
"middle_name": "ALLEN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA10774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.