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

Mrs. Kristen J Waggoner, PA

Individual provider Physician Assistant · NPI 1174827190

Mrs. Kristen J Waggoner, PA is a Physician Assistant in Fair Oaks, California. Qualified in 2008, 18 years ago. Practices with Sutter Valley Medical Foundation, a 2,464-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
18
Licensed in
CA
In the registry since
2011
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

4944 Sunrise Blvd Ste H
Fair Oaks, CA 95628-4941
Phone: (916) 966-8158
Fax: (916) 966-8118
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 20275 (CA)

Record details

NPI number1174827190
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJanuary 5, 2011
Last updated in NPPESNovember 4, 2014

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Sutter Valley Medical Foundation — 2464 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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