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

Penny Lane Makabenta, PA

Individual provider Physician Assistant · NPI 1245439157

Penny Lane Makabenta, PA is a Physician Assistant in Fullerton, California. Qualified in 2005, 21 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
21
Licensed in
CA
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2720 N Harbor Blvd Ste 130
Fullerton, CA 92835-2609
Phone: (714) 449-6230
Fax: (714) 449-1773
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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 PA18214 (CA)

Record details

NPI number1245439157
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 12, 2007
Last updated in NPPESJuly 12, 2007

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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