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

Jacob Vinson

Individual provider Physician Assistant · NPI 1396339974

Jacob Vinson is a Physician Assistant in Fresno, California. Qualified in 2021, 5 years ago. Practices with Central California Faculty Medical Group Inc, a 254-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

2823 Fresno St
Fresno, CA 93721-1324
Phone: (559) 459-5194
Fax: (559) 459-3719
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 59205 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 59205 (CA)

Record details

NPI number1396339974
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 24, 2021
Last updated in NPPESAugust 5, 2021
Certification dateAugust 5, 2021
Mailing address2625 E Divisadero St, Fresno, CA 93721-1431

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Central California Faculty Medical Group Inc — 254 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fresno