Jessica D Fan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA53780 Issued in CA

Practice address

981 W Foothill Blvd
Claremont, CA 91711-3304

Phone

(909) 667-7769

NPI assigned

Sep 27, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Vera Dermatology Inc

  • Dermatology Physician
  • Claremont, CA
  • NPI 1386397917
  NPD

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1982153292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 W FOOTHILL BLVD",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113304",
            "telephone_number": "909-667-7769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "981 W FOOTHILL BLVD",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113304",
            "telephone_number": "909-667-7769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "JESSICA",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA53780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nessa Eugene, MS SLP
• Exercising Enterprises
• Fairley Physical Therapy, Inc
• Jeffrey Laurence Fairley, PT, DPT, OCS
• Rebecca Michelle Fairley, PT, MPT, CSCS
• Julianna Farinella
• Tona Renee Farlow, LMFT
• Darren Alan Favela, PA-C
• Marilyn Fay
• Michael L Fernandez

• Medical Physician Assistant in Claremont, CA
• Providers in Claremont, 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 11, 2023; 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.