JASMINE KETTLEY PA-C
NPI 1942514708
Physician Assistant - Surgical in Sacramento, CA

Q: What is the provider's specialty?

The provider's specialty is Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.

Active since August 03, 2010PECOS Enrolled

3701 J ST, SUITE # 109, SACRAMENTO, CA 95816(734) 358-7418 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Jasmine Kettley Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JASMINE KETTLEY PA-C (NPI 1942514708) is an individual surgical provider in Sacramento, California, licensed in California (PA21683) and active in the NPI registry since August 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1942514708

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameJASMINE KETTLEYCredential: PA-C

Location Address3701 J ST, SUITE # 109Sacramento, CA 95816-5562

Mailing Address3701 J St, Suite # 109Sacramento, CA 95816-5562 · (734) 358-7418

Phone(734) 358-7418

Sole ProprietorNo

Enumeration DateAugust 3, 2010

Last NPPES UpdateJanuary 3, 2022

✔ NPI 1942514708 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in CA · PA21683

3701 J ST, Sacramento, CA 95816

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jasmine Kettley Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.