Individual provider Active NPI

Adrienne Dorothy Kane, PA

  • Physician Assistant
  • Stockton, CA
National Provider Identifier
1720225766
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52981 Issued in CA
Practice address
582 E Harding Way
Stockton, CA 95204-6110
Phone
(888) 530-4415
Fax
(844) 226-9193
NPI assigned
Jan 13, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 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 52981 CA Primary

Addresses

Primary practice location

582 E Harding Way
Stockton, CA 95204-6110

Mailing address

3130 Balfour Rd Ste D-104
Brentwood, CA 94513-5515

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
I20161201000754 CA Order and Referring Only - Physician Assistant 1052691409

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52981CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: adrienne.kane.1@17371.direct.athenahealth.com

Organizations & group practices 1

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": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1720225766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 BALFOUR RD STE D-104",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 E HARDING WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046110",
            "telephone_number": "888-530-4415",
            "fax_number": "844-226-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "ADRIENNE",
        "middle_name": "DOROTHY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-13",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.