Provider Demographics
NPI:1427890656
Name:CARTER, MICHELLE CLAUDETTE (PA-C)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CLAUDETTE
Last Name:CARTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 LA CRESENTA RD
Mailing Address - Street 2:
Mailing Address - City:EL SOBRANTE
Mailing Address - State:CA
Mailing Address - Zip Code:94803-2919
Mailing Address - Country:US
Mailing Address - Phone:702-785-3922
Mailing Address - Fax:
Practice Address - Street 1:2415 HIGH SCHOOL AVE STE 800
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1858
Practice Address - Country:US
Practice Address - Phone:925-687-5210
Practice Address - Fax:925-687-5091
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA65886363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty