| Jaidesh Reddick, PAC | |
|
551 Mccray St, Hollister, CA 95023-4090 | |
| (831) 634-4444 | |
| (831) 634-4440 |
| Full Name | Jaidesh Reddick |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 551 Mccray St, Hollister, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013099753 | NPI | - | NPPES |
| PA16397 | Other | CA | CA LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA16397 (California) | Primary |
| Entity Name | County of Santa Clara |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699885079 PECOS PAC ID: 1254244973 Enrollment ID: O20040113000784 |
| Mailing Address | Practice Location Address |
|---|---|
| Jaidesh Reddick, PAC 551 Mccray St, Hollister, CA 95023-4090 Ph: (831) 634-4444 | Jaidesh Reddick, PAC 551 Mccray St, Hollister, CA 95023-4090 Ph: (831) 634-4444 |
Amelia Underwood I, RD, CDE, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 591 Mccray St Ste 231, Hollister, CA 95023 Phone: 831-444-2289 |
Mr. Sung Jin Park, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1000 Fairview Rd, Hollister, CA 95023 Phone: 714-545-5550 Fax: 949-609-0374 |
Mr. Ray S. Kusumoto, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 591 Mccray St Ste 231, Hollister, CA 95023 Phone: 831-636-3116 Fax: 831-636-1204 |
Thomas H Zdimal, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 911 Sunset Dr, Hollister, CA 95023 Phone: 831-636-2640 |
Susana Frasher, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 911 Sunset Dr, Hollister, CA 95023 Phone: 831-636-2640 |
Nicole Ann Shelton, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 930 Sunnyslope Rd Ste E3, Hollister, CA 95023 Phone: 831-630-1477 |
Lori A Kraus, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 911 Sunset Dr, Hollister, CA 95023 Phone: 831-636-2664 Fax: 831-636-2641 |