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

Jessica Fogeltanz, PA

Individual provider Physician Assistant · NPI 1477942647

Jessica Fogeltanz, PA is a Physician Assistant in Camarillo, California. Qualified in 2014, 12 years ago. Practices with Daniel Ghiyam MD Inc, a 4-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
12
In the registry since
2015
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1880 Del Ciervo Pl
Camarillo, CA 93012-4066
Phone: (805) 479-8682
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1477942647
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 12, 2015
Last updated in NPPESJanuary 12, 2015

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Daniel Ghiyam Md Inc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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