Individual provider Active NPI

Veshudha Kang, PHYSICIAN ASSISTANT

  • Surgical Physician Assistant
  • Fresno, CA
National Provider Identifier
1881212397
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
58452 Issued in CA
Practice address
2615 E Clinton Ave
Fresno, CA 93703-2223
Phone
(559) 225-6100
NPI assigned
Jul 10, 2020
Last updated
Sep 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 58452 CA Primary

Addresses

Primary practice location

2615 E Clinton Ave
Fresno, CA 93703-2223

Mailing address

PO Box 3129
Pinedale, CA 93650-3129
Phone (559) 706-8519

Other practice location 1

1510 E Herndon Ave Ste 210
Fresno, CA 93720-3333
Phone (559) 450-7200

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
I20250206002045 CA Practitioner - Physician Assistant 4284164245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Agnes Medical FoundationGroup PAC ID 7618946369, 161 clinicians
California Dreams Medical Corporation PCGroup PAC ID 7113353160, 21 clinicians

Practice addresses (Care Compare)

1105 E Spruce Ave
Fresno, CA 93720-3313
Phone (559) 450-2630

1221 E Spruce Ave
Fresno, CA 93720-3374
Phone (559) 450-5777

1303 E Herndon Ave
Fresno, CA 93720-3309
Phone (559) 450-3433

1379 E Herndon Ave
Fresno, CA 93720-3309
Phone (559) 450-6388

3656 W Shaw Ave
Fresno, CA 93711-3231
Phone (559) 823-5252

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58452CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
LQMG Medical Group Inc. Current Accepting new patients
Saint Agnes Medical Foundation CurrentSince Aug 29, 2025 Accepting new patients

Locations

1221 E Spruce Ave
Fresno, CA 93720
Phone (559) 449-5777

1510 E Herndon Ave
Ste 210
Fresno, CA 93720
Phone (559) 450-7200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1881212397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3129",
            "city": "PINEDALE",
            "state": "CA",
            "postal_code": "936503129",
            "telephone_number": "559-706-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 E CLINTON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937032223",
            "telephone_number": "559-225-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 E Herndon Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203333",
            "country_code": "US",
            "telephone_number": "559-450-7200",
            "fax_number": "559-450-7214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "VESHUDHA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "58452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.