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

Nicholas Joseph Pena, PA-C

Individual provider Physician Assistant · NPI 1083176077

Nicholas Joseph Pena, PA-C is a Physician Assistant in Ontario, California. Qualified in 2018, 8 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California and Washington.

Years since qualifying
8
Licensed in
CA, WA
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2295 S Vineyard Ave
Ontario, CA 91761-7925
Phone: (888) 750-0036
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (2)

  • 2501 E Chapman Ave Ste 101, Orange, CA 92869-3204 — (714) 628-3300
  • 2850 Se Powell Valley Rd, Gresham, OR 97080-1494 — (503) 666-5050

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 56636 (CA)
Physician Assistant Taxonomy 363A00000X · Licence PA61575377 (WA)

Record details

NPI number1083176077
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedApril 1, 2019
Last updated in NPPESMarch 7, 2025
Certification dateMarch 7, 2025
Mailing address385 S Manchester Ave, Unit 2109, Orange, CA 92868-3250

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

Other providers in Ontario