Provider Demographics
NPI:1356673214
Name:AYERS, GAY D (PA)
Entity Type:Individual
Prefix:
First Name:GAY
Middle Name:D
Last Name:AYERS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MILL VALLEY CIR N
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-2171
Mailing Address - Country:US
Mailing Address - Phone:916-613-4325
Mailing Address - Fax:
Practice Address - Street 1:4460 DUCKHORN DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-2593
Practice Address - Country:US
Practice Address - Phone:916-977-0122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13039363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical