Individual provider Active NPI

Veronica Therese Chicco, PA

  • Physician Assistant
  • San Fernando, CA
National Provider Identifier
1285367458
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1222433 Issued in CA
Practice address
107 N Maclay Ave
San Fernando, CA 91340-2906
Phone
(818) 697-8585
NPI assigned
Jul 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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 1222433 CA Primary

Addresses

Primary practice location

107 N Maclay Ave
San Fernando, CA 91340-2906

Mailing address

107 N Maclay Ave
San Fernando, CA 91340-2906
Phone (818) 697-8585

Other names 1

  • Veronica Therese Raygoza Former name

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
I20260225003185 CA Practitioner - Physician Assistant 6406337690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3250 Wilshire Blvd
Suite 1101
Los Angeles, CA 90010-1513

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1222433CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Los Angeles Medical Group, Inc. CurrentSince Feb 11, 2026 Accepting new patients
Ali Anari MD Inc CurrentSince Oct 13, 2024 Accepting new patients
Anari Medical Corp PastSince Oct 13, 2024 Accepting new patients

Locations

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

107 N Maclay Ave
San Fernando, CA 91340
Phone (714) 804-9293

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDACDD

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": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1285367458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N MACLAY AVE",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913402906",
            "telephone_number": "818-697-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N MACLAY AVE",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913402906",
            "telephone_number": "818-697-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHICCO",
        "first_name": "VERONICA",
        "middle_name": "THERESE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "1222433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VERONICA",
            "last_name": "RAYGOZA",
            "middle_name": "THERESE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Fernando, CA

Sources for this page

Verify at the official NPI Registry.