Individual provider Active NPI

Lili Duong, PA-C

  • Physician Assistant
  • Carmichael, CA
National Provider Identifier
1952123648
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6101 Fair Oaks Blvd
Carmichael, CA 95608-4895
Phone
(916) 296-0561
NPI assigned
Oct 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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 CA Primary

Addresses

Primary practice location

6101 Fair Oaks Blvd
Carmichael, CA 95608-4895

Mailing address

12660 Ivanhoe Rd
Lucerne Valley, CA 92356-8292
Phone (760) 987-4936

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
I20241203002448 CA Practitioner - Physician Assistant 3971038746 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65371CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spine & Nerve Diagnostic Center CurrentSince Oct 20, 2025 Accepting new patients
Spine & Nerve Diagnostic Center CurrentSince Oct 20, 2025 Accepting new patients
Regents of the University of California CurrentSince Feb 1, 2025 Accepting new patients
Regents of the University of California CurrentSince Feb 1, 2025 Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

1528 Eureka Rd
Ste 103
Roseville, CA 95661
Phone (916) 772-5325

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

4860 Y St
Ste 1600
Sacramento, CA 95817
Phone (916) 734-2833

Interoperability endpoints

  • Direct secure messaging: lduong763422@hisp.ehr.sutterhealth.org

Organizations & group practices 7

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": "1729814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1952123648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12660 IVANHOE RD",
            "city": "LUCERNE VALLEY",
            "state": "CA",
            "postal_code": "923568292",
            "telephone_number": "760-987-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 FAIR OAKS BLVD",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956084895",
            "telephone_number": "916-296-0561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "LILI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

Verify at the official NPI Registry.