Jerrold Paul Elliott III, PA-C
Jerrold Paul Elliott III, PA-C is a Physician Assistant in Guerneville, California. Qualified in 2008, 18 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group and accepts Medicare assignment. Licensed in California and Colorado.
- Years since qualifying
- 18
- Licensed in
- CA, CO
- In the registry since
- 2008
- Specialties on file
- 2
What do these letters mean?
- PA-C — Physician Assistant, Certified
- A physician assistant who holds current national certification.
Practice location Address checks out
16319 Third StGuerneville, CA 95446
Phone: (707) 869-5977
Fax: (707) 869-5983
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
| Medical Physician Assistant (primary) | Taxonomy 363AM0700X · Licence PA20527 (CA) |
|---|---|
| Physician Assistant | Taxonomy 363A00000X · Licence 2666 (CO) |
Record details
| NPI number | 1982854618 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA-C |
| Sole proprietor | No |
| NPI enumerated | September 30, 2008 |
| Last updated in NPPES | January 25, 2021 |
| Certification date | January 25, 2021 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2008 (18 years in practice) |
| Group practice | Providence Medical Foundation — 1465 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 4 on file with Medicare |