Provider Demographics
NPI:1134584014
Name:SCHMIDT, JUSTIN (PA-C)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 PLAZA DR STE 204
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6954
Mailing Address - Country:US
Mailing Address - Phone:805-739-3877
Mailing Address - Fax:805-346-3539
Practice Address - Street 1:525 PLAZA DR STE 204
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6954
Practice Address - Country:US
Practice Address - Phone:805-739-3877
Practice Address - Fax:805-346-3539
Is Sole Proprietor?:No
Enumeration Date:2015-12-21
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA53125363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant