Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carly Akemi Takata

Individual provider Physician Assistant · NPI 1013768217

Carly Akemi Takata is a Physician Assistant in Santa Ana, California. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2024
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Practice location Address checks out

5 Hutton Centre Dr Ste 950
Santa Ana, CA 92707-8744
Phone: (855) 434-7763
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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 PA64869 (CA)

Record details

NPI number1013768217
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 27, 2024
Last updated in NPPESSeptember 15, 2025
Certification dateSeptember 15, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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