Viviana Giselle Velazquez

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64627 Issued in CA

Practice address

1021 W Martin Luther King Jr Blvd
Los Angeles, CA 90037-1816

Phone

(310) 279-6656

NPI assigned

Jul 4, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Universal Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1093023277
  Medicare reassignment
• Universal Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1174913776
  NPD
• Universal Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1295493310
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1033842471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W MARTIN LUTHER KING JR BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900371816",
            "telephone_number": "310-279-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 W MARTIN LUTHER KING JR BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900371816",
            "telephone_number": "310-279-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "VIVIANA",
        "middle_name": "GISELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morelia Velazquez
• Paulina Velazquez
• Raul Velazquez, D.M.D.
• Sarah Marie Velazquez
• Susan Velazquez
• Mark Veldkamp
• Angela Avelina Veles Gonzalez
• Mary Veleta, MSW
• Joana Velete
• Diana Veletyan

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.