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

Justin Mikesell

Individual provider Physician Assistant · NPI 1649991720

Justin Mikesell is a Physician Assistant in Thousand Oaks, California. Qualified in 2022, 4 years ago. Practices with Pacifica Dermatology, a 2-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
4
Licensed in
CA
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

3095 Old Conejo Rd Ste 200
Thousand Oaks, CA 91320-2130
Phone: (805) 298-7034
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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 61471 (CA)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1649991720
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 7, 2022
Last updated in NPPESSeptember 7, 2022
Certification dateSeptember 7, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Pacifica Dermatology — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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