Active NPI
Ericka Carmen Carranza-Perez, PA-C
- Physician Assistant
- Modesto, CA
National Provider Identifier
1295084259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA22514
- Practice address
- 1700 McHenry Village Way
Suite 2
Modesto, CA 95350-4308 - Phone
- (209) 549-1057
- NPI assigned
- Sep 6, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA22514 | CA | Primary |
Addresses
Primary practice location
1700 McHenry Village Way
Suite 2
Modesto, CA 95350-4308
Mailing address
PO Box 40
Hughson, CA 95326-0040
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140820000751 | CA | Order and Referring Only - Physician Assistant | 2062617897 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22514 | CA | MD | Pediatric Physical Therapist |
| PA22514 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421193600000",
"number": "1295084259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 40",
"city": "HUGHSON",
"state": "CA",
"postal_code": "953260040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 MCHENRY VILLAGE WAY",
"address_2": "SUITE 2",
"city": "MODESTO",
"state": "CA",
"postal_code": "953504308",
"telephone_number": "209-549-1057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRANZA-PEREZ",
"first_name": "ERICKA",
"middle_name": "CARMEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-06",
"last_updated": "2015-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA22514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.