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

Jon Ukishima, PA-C

Individual provider Physician Assistant · NPI 1548709983

Jon Ukishima, PA-C is a Physician Assistant in Fullerton, California. Qualified in 2016, 10 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
10
Licensed in
CA
In the registry since
2017
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

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone: (714) 992-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 54228 (CA)

Record details

NPI number1548709983
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 17, 2017
Last updated in NPPESJanuary 6, 2022
Mailing address12465 Hazeltine Dr, Tustin, CA 92782-1139

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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