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

Individual provider Physician Assistant · NPI 1487118105

Rodney Gerrit Dekleuver, PHYSICIANASSISTANT is a Physician Assistant in Santa Rosa, California. Qualified in 2018, 8 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
8
Licensed in
CA
In the registry since
2019
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Practice location Address checks out

1405 Montgomery Dr
Santa Rosa, CA 95405-4557
Phone: (707) 522-5411
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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 56437 (CA)

Record details

NPI number1487118105
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedJanuary 27, 2019
Last updated in NPPESJanuary 27, 2019

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 locations3 on file with Medicare

Other providers in Santa Rosa