Individual provider Active NPI

Michelle Son, PA-C

  • Medical Physician Assistant
  • Stockton, CA
National Provider Identifier
1760175897
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA62728 Issued in CA
Practice address
2626 N California St Ste B
Stockton, CA 95204-5500
Phone
(209) 466-2626
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA62728 CA Primary

Addresses

Primary practice location

2626 N California St Ste B
Stockton, CA 95204-5500

Mailing address

2626 N California St Ste B
Stockton, CA 95204-5500

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
I20231012001700 CA Practitioner - Physician Assistant 0648625525 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

4501 X St
Sacramento, CA 95817-2229
Phone (916) 734-5959

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62728CAMDDentist
PA62728CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of Ca CurrentSince Sep 17, 2025 Accepting new patients
Mark Twain Medical Center CurrentSince Sep 11, 2024 Accepting new patients
Regents of the Univ of Ca CurrentSince Sep 17, 2025 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

4501 X St
Fl 2
Sacramento, CA 95817
Phone (916) 734-5959

4501 X St
Sacramento, CA 95817
Phone (916) 734-5959

768 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 464-6422

Organizations & group practices 6

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 2

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": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1760175897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 N CALIFORNIA ST STE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 N CALIFORNIA ST STE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045500",
            "telephone_number": "209-466-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SON",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA62728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.