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

Individual provider Community/Behavioral Health Agency · NPI 1245821669

Jerrica Park, PA-C is a Community/Behavioral Health Agency in Flagstaff, Arizona. Practices as a sole proprietor and works from 2 locations. Licensed in Arizona and California.

Licensed in
AZ, CA
In the registry since
2021
Specialties on file
3
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

1120 W University Ave Ste 101
Flagstaff, AZ 86001-2851
Phone: (928) 522-1300
Fax: (928) 522-1301
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2100 Statham Blvd, Oxnard, CA 93033 — (805) 920-7021

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X
Physician Assistant Taxonomy 363A00000X · Licence 9452 (AZ)
Physician Assistant Taxonomy 363A00000X · Licence 65593 (CA)

Record details

NPI number1245821669
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJanuary 28, 2021
Last updated in NPPESJune 17, 2026
Certification dateJune 17, 2026

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