Viridiana Simona Van Den Hengel-Gomez, PA65426
Individual provider Active NPI Physician Assistant · Winters, CA
NPI 1124871801 · NPPES record last updated Nov 2, 2025
Key facts
- NPI
- 1124871801
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA65426 (CA)
- Practice address
- 172 E Grant Ave
Winters, CA 95694-1780 - Phone
- (916) 734-2145
- Fax
- (530) 795-3054
- NPI assigned
- Apr 10, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250415003533 | CA | Practitioner - Physician Assistant | 0244755965 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65426 | CA | MD | Marriage & Family Therapist |
| PA65426 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Winters Healthcare Foundation, Inc. | Current |
Accepting new patients |
Locations
17340 Yolo Ave
Esparto, CA 95627
Phone (530) 787-3454
172 E Grant Ave
Winters, CA 95694
Phone (530) 212-1025
Interoperability endpoints
- vvandanhengel768857@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA65426 | CA | Yes |
Addresses
Primary practice location
172 E Grant Ave
Winters, CA 95694-1780
Mailing address
224 Raleigh Dr
Vacaville, CA 95687-6636
Phone (530) 787-3454
Other names
- Viridiana Simona Van Den Hengel-Gomez
Other providers in Winters, CA
- Sutter Valley Medical Foundation
- Michael Tang
- Andrea Corinne Trader-McKenna
- Linda Tsang
- Brittany N Vacura Sarris
- We Care 4 Yolo LLC
- Winters Healthcare Foundation, Inc.
- Winters Healthcare Foundation, Inc.
- Winters Joint Unified School District
- Kate A Woodard
All providers in Winters, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.