Troy G Fajerson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA12188 Issued in CA

Practice address

632 W Gibson Rd
Woodland, CA 95695

Phone

(530) 666-1631

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1962420869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 W GIBSON RD",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "95695",
            "telephone_number": "530-666-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 W GIBSON RD",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "95695",
            "telephone_number": "530-666-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJERSON",
        "first_name": "TROY",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA12188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "PA12188",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00061967",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel Joseph Estrada-Vazquez
• Ian Evans, LMFT
• Evvy Shan
• Eyes of Woodland Optometry, Apc
• Shazia Faiz, M.D
• Jennifer Brooke Fallon, BSW
• Katherine Fan
• Joan Elizabeth Fanucchi, B.S.N., R.N., P.H.N.
• Lindsay Nicole Farewell
• Elicia Faulk Ladd

• Medical Physician Assistant in Woodland, CA
• Providers in Woodland, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.