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

Imelda Miranda Mata

Individual provider Physician Assistant · NPI 1134731268

Imelda Miranda Mata is a Physician Assistant in Chico, California. Qualified in 2017, 9 years ago. Practices with Hodari MD Dermatology Inc, a 9-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
9
Licensed in
CA
In the registry since
2020
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

80 Declaration Dr
Chico, CA 95973-4900
Phone: (530) 894-6832
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 56624 (CA)

Record details

NPI number1134731268
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 19, 2020
Last updated in NPPESAugust 19, 2020
Certification dateAugust 19, 2020
Mailing address4944 Will T Rd, Chico, CA 95973-9411

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Hodari Md Dermatology Inc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Chico