Individual provider Active NPI

Kaitlyn Friesen, PA-C

  • Physician Assistant
  • Placerville, CA
National Provider Identifier
1992677850
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
66663 Issued in CA
Practice address
1100 Marshall Way
Placerville, CA 95667-6533
Phone
(530) 626-2717
NPI assigned
Sep 20, 2025
Last updated
Oct 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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 66663 CA Primary

Addresses

Primary practice location

1100 Marshall Way
Placerville, CA 95667-6533

Mailing address

PO Box 553
Folsom, CA 95763-0553

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
I20260302000136 CA Practitioner - Physician Assistant 0446732382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

1100 Marshall Way
Placerville, CA 95667-6533
Phone (530) 626-2717

4201 Town Ctr Blvd
BLDG D
El Dorado Hills, CA 95762-7100
Phone (916) 905-6378

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
66663CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center Multi-Specialty CurrentSince Apr 1, 2026 Accepting new patients
Emergency Medicine Physician Partners of El Dorado County, Inc Multi-Specialty CurrentSince Feb 16, 2026 Accepting new patients
Marshall Medical Center CurrentSince Apr 1, 2026 Accepting new patients

Locations

4201 Town Center Blvd
Bldg D
El Dorado Hills, CA 95762
Phone (530) 344-5400

1100 Marshall Way
Placerville, CA 95667
Phone (530) 626-2601

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": "1758326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1992677850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 553",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "957630553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MARSHALL WAY",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676533",
            "telephone_number": "530-626-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIESEN",
        "first_name": "KAITLYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-20",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "66663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.