Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Annmarie Alexus Moreno, PA-CMSPA

Individual provider Physician Assistant · NPI 1215124854

Annmarie Alexus Moreno, PA-CMSPA is a Physician Assistant in Lancaster, California. Graduated from Western University of Health Sciences College of Dental Med in 2007, 19 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
19
Trained at
Western University of Health Sciences College of Dental Med
Licensed in
CA
In the registry since
2007
Specialties on file
2
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Practice location Address checks out

43821 15th St W
Lancaster, CA 93534-4756
Phone: (661) 670-9814
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 19356 (CA)
Physician Assistant Taxonomy 363A00000X · Licence PA19356 (CA)

Record details

NPI number1215124854
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-CMSPA
Sole proprietorNo
NPI enumeratedSeptember 27, 2007
Last updated in NPPESOctober 15, 2024
Certification dateJune 20, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolWESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
Graduated 2007 (19 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Lancaster