Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ETHAN SHAKEEL JEFFERSON, PA-C
ActiveETHAN SHAKEEL JEFFERSON, PA-C is a Family Medicine healthcare provider located in GRASS VALLEY, California. NPI 1275358806 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · GRASS VALLEY, CA
Registration Details
- NPI Number
- 1275358806
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 19, 2024 (1.5504963913732 yrs)
- Last Updated
- Dec 3, 2025
- License
-
67370 (CA)
Practice Information
- Address
-
280 SIERRA COLLEGE DR STE 207GRASS VALLEY, CA, 959455769Browse CA providers · Browse ZIP 95945
- Phone
- 5304777390
- Fax
- 5304777389
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in GRASS VALLEY, CA
| Name | Credential | NPI |
|---|---|---|
| DR. JAMES WILLIAM NICHOL | M.D. | 1114924966 |
| DR. BURNELL VASSAR | M.D. | 1548268386 |
| DR. GARRETT M. ECKERLING | M.D. | 1215937388 |
| DR. FRANK JOHN LANG JR. | M.D. | 1417942939 |
| VERONICA S MINIER | MD | 1720050909 |
| JILL ELIZABETH FITZPATRICK | MD | 1689640658 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.