Provider Demographics
NPI:1245240118
Name:SIMARD, JANE KAREN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:KAREN
Last Name:SIMARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:JANE
Other - Middle Name:KAREN
Other - Last Name:PICKERING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1579 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-9293
Mailing Address - Country:US
Mailing Address - Phone:530-261-1044
Mailing Address - Fax:
Practice Address - Street 1:1579 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-9293
Practice Address - Country:US
Practice Address - Phone:530-261-1044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA15925207Q00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1245240118Medicaid
CAPA15925Medicaid
CABF681YMedicare PIN
CA0PA159250Medicare PIN