Individual provider Active NPI

Jesirey Ivan D Locquiao, PA-C

  • Physician Assistant
  • Bakersfield, CA
National Provider Identifier
1720420508
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA23079 Issued in CA
Practice address
3001 Sillect Ave
Bakersfield, CA 93308-6337
Phone
(661) 316-6000
NPI assigned
Jul 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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 PA23079 CA Primary

Addresses

Primary practice location

3001 Sillect Ave
Bakersfield, CA 93308-6337

Mailing address

12618 Willowdale Dr
Bakersfield, CA 93312-6552
Phone (661) 487-5643

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
I20150331000085 CA Practitioner - Physician Assistant 5193042281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health Physicians NetworkGroup PAC ID 3274580972, 628 clinicians

Practice addresses (Care Compare)

2701 Chester Ave
Bakersfield, CA 93301-2016

8311 Brimhall Rd
Suite 1901
Bakersfield, CA 93312-4369
Phone (661) 638-0601

Hospital & facility affiliations

  • Adventist Health Bakersfield Hospital, Bakersfield, CA, CCN 050455

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA23079CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network CurrentSince Jul 21, 2025 Accepting new patients
Adventist Health Heart Institute-Ukiah Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1720420508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12618 WILLOWDALE DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933126552",
            "telephone_number": "661-487-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SILLECT AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933086337",
            "telephone_number": "661-316-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCQUIAO",
        "first_name": "JESIREY IVAN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA23079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.