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

Dustin K Wetmore, PA-C

Individual provider Physician Assistant · NPI 1710320437

Dustin K Wetmore, PA-C is a Physician Assistant in Santa Rosa, California. Qualified in 2012, 14 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
14
Licensed in
CA
In the registry since
2013
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

121 Sotoyome St Ste 201
Santa Rosa, CA 95405
Phone: (707) 308-3101
Fax: (707) 546-4062
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 501 Lighthouse Ave, Monterey, CA 93940-1439 — (831) 649-0770
  • 501 Lighthouse Ave, Monterey, CA 93940-1439 — (831) 649-0770
  • 1165 Montgomery Dr, Santa Rosa, CA 95405-4801 — (707) 303-1709

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA22901 (CA)

Record details

NPI number1710320437
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 11, 2013
Last updated in NPPESNovember 11, 2021
Certification dateNovember 11, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Santa Rosa