Individual provider Active NPI

Violeta Chavez-Serrano

  • Occupational Therapist
  • Vista, CA
National Provider Identifier
1114792017
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT25655 Issued in CA
Practice address
1840 West Dr
Vista, CA 92083-6115
Phone
(619) 205-4585
NPI assigned
Nov 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT25655 CA Primary

Addresses

Primary practice location

1840 West Dr
Vista, CA 92083-6115

Mailing address

502 Taylor St
Vista, CA 92084-2538
Phone (818) 935-4339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25655CAMDGeneral Practice Dentistry
OT25655CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Dec 19, 2023 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc CurrentSince Dec 19, 2023 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients

Locations

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

1601 Precision Park Ln
San Ysidro, CA 92173
Phone (619) 205-4585

1840 West Dr
Vista, CA 92083
Phone (619) 205-4585

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1114792017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 TAYLOR ST",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920842538",
            "telephone_number": "818-935-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 WEST DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836115",
            "telephone_number": "619-205-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ-SERRANO",
        "first_name": "VIOLETA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT25655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.