Provider Demographics
NPI:1811708902
Name:SAVITZ, JAIME (PA-C, RDN)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:SAVITZ
Suffix:
Gender:
Credentials:PA-C, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26520 CACTUS AVE STE A2006
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-3927
Mailing Address - Country:US
Mailing Address - Phone:951-486-4460
Mailing Address - Fax:951-486-6510
Practice Address - Street 1:26520 CACTUS AVE STE A2006
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-3927
Practice Address - Country:US
Practice Address - Phone:951-486-4460
Practice Address - Fax:951-486-6510
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA65722363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA65722OtherPHYSICIAN ASSISTANT BOARD