Individual provider Active NPI

Letty S. Echeverria, PA-C

  • Physician Assistant
  • Visalia, CA
National Provider Identifier
1104251065
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 23183 Issued in CA
Practice address
1633 S Court St
Visalia, CA 93277-4945
Phone
(559) 624-6090
NPI assigned
Sep 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 23183 CA Primary

Addresses

Primary practice location

1633 S Court St
Visalia, CA 93277-4945

Mailing address

5010 W Wagner Ave
Visalia, CA 93277-5611
Phone (559) 280-1888

Other practice location 1

5010 W Wagner Ave
Visalia, CA 93277-5611
Phone (559) 280-1888

Other identifiers 1

IdentifierTypeStateIssuer
PA 23183OtherCAPA LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140103001190 CA Practitioner - Physician Assistant 4981832581 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
23183CAMDChiropractor
PA 23183CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaweah Delta Health Care District CurrentSince Dec 8, 2014 Accepting new patients
Visalia Medical Clinic, Inc. Current Accepting new patients
Lodi Memorial Hospital Association Inc CurrentSince May 1, 2022 Accepting new patients
Kaweah Delta Health Care District CurrentSince Dec 8, 2014 Accepting new patients

Locations

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

5400 W Hillsdale Ave
Visalia, CA 93291
Phone (553) 733-5222

1633 S Court St
Visalia, CA 93277
Phone (559) 624-6090

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1104251065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 W WAGNER AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932775611",
            "telephone_number": "559-280-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 S COURT ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932774945",
            "telephone_number": "559-624-6090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5010 W Wagner Ave",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932775611",
            "country_code": "US",
            "telephone_number": "559-280-1888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ECHEVERRIA",
        "first_name": "LETTY",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-11",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 23183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA 23183",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.