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

Jason Lopez, PA

Individual provider Physician Assistant · NPI 1497245138

Jason Lopez, PA is a Physician Assistant in Fullerton, California. Qualified in 2018, 8 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
8
Licensed in
CA
In the registry since
2018
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

100 E Valencia Mesa Dr Ste 310
Fullerton, CA 92835-3800
Phone: (714) 734-3120
Show map & directions

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

Additional practice locations (1)

  • 2823 Fresno St, Fresno, CA 93721-1324 — (559) 459-3705

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 55964 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 55964 (CA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 55964 (CA)

Record details

NPI number1497245138
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 17, 2018
Last updated in NPPESJuly 13, 2021
Certification dateJuly 13, 2021
Mailing address100 E Valencia Mesa Dr Ste 310, Fullerton, CA 92835-3800

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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