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

Takara Dickson, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1184249146

Takara Dickson, PHYSICIANASSISTANT is a Physician Assistant in Fairfield, California. Graduated from University of Utah School of Medicine in 2021, 5 years ago. Practices with Northbay Physicians Surgery Center, LLC, a 337-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
5
Trained at
University of Utah School of Medicine
Licensed in
CA
In the registry since
2020
Specialties on file
3
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Practice location Address checks out

1860 Pennsylvania Ave Ca Ste 110
Fairfield, CA 94533-3550
Phone: (707) 646-4414
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 375 S Chipeta Way, Salt Lake City, UT 84108-1260 — (801) 585-0187

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA60134 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 60134 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1184249146
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedJune 15, 2020
Last updated in NPPESJanuary 25, 2023
Certification dateJanuary 25, 2023
Mailing address1860 Pennsylvania Ave Ca, Ste 110, Fairfield, CA 94533-3550

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice Northbay Physicians Surgery Center, Llc — 337 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Fairfield