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

Jacqueline Hayata

Individual provider Physician Assistant · NPI 1861071102

Jacqueline Hayata is a Physician Assistant in Los Angeles, California. Qualified in 2021, 5 years ago. Practices with Modern Concepts Medical Group Inc, a 6-clinician group and accepts Medicare assignment. Licensed in California.

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

221 Westwood Plz
Los Angeles, CA 90095-4103
Phone: (310) 825-4073
Fax: (310) 983-1172
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (CA)

Record details

NPI number1861071102
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 5, 2021
Last updated in NPPESJune 25, 2026
Certification dateJune 25, 2026

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 Modern Concepts Medical Group Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Los Angeles