Individual provider · Type 1 NPI

Takara Dickson, PHYSICIAN ASSISTANT

Medical Physician Assistant · Fairfield, CA

NPI number 1184249146 Active

Practice location

1860 Pennsylvania Ave Ca, Ste 110
Fairfield, CA 94533-3550

Call (707) 646-4414 Map

Other practice locations

  • 375 S Chipeta Way, Salt Lake City, UT 84108-1260 · (801) 585-0187

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X60134 (CA)
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Medical Physician Assistant Primary 363AM0700XPA60134 (CA)

Medical Physician Assistant: Definition to come...

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About NPI 1184249146

Takara Dickson, PHYSICIAN ASSISTANT's National Provider Identifier is 1184249146, issued on Jun 15, 2020. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Fairfield, CA. The record was last updated on Jan 25, 2023.