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

Stacy Jo Williams, PA-C

Individual provider Physician Assistant · NPI 1629031984

Stacy Jo Williams, PA-C is a Physician Assistant in Folsom, California. Qualified in 2004, 22 years ago. Practices with Golden State Dermatology Associates, Inc, a 119-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and Texas.

Years since qualifying
22
Licensed in
CA, TX
In the registry since
2006
Specialties on file
3
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

192 Blue Ravine Rd # 100
Folsom, CA 95630-4771
Phone: (916) 983-3373
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 (1)

  • 5601 J St, Sacramento, CA 95819-3948 — (916) 454-5922

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA19518 (CA)
Physician Assistant Taxonomy 363A00000X · Licence PA04348 (TX)
Physician Assistant Taxonomy 363A00000X · Licence PA19518 (CA)

Record details

NPI number1629031984
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 8, 2006
Last updated in NPPESNovember 26, 2024
Certification dateNovember 26, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Golden State Dermatology Associates, Inc. — 119 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Folsom