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

Nicolette Rose Campbell, PA-C

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1194584300

Nicolette Rose Campbell, PA-C is a Physician Assistant in Fontana, California. Qualified in 2023, 3 years ago. Practices with Carbon Health Medical Group of California PC, a 332-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2024
Specialties on file
2
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

9395 Emerald Ave
Fontana, CA 92335-5819
Phone: (954) 673-9749
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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 64407 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1194584300
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 18, 2024
Last updated in NPPESOctober 16, 2024
Certification dateOctober 16, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Carbon Health Medical Group Of California Pc — 332 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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