Individual provider Active NPI

Carolina Granados Homan, PA-C

  • Physician Assistant
  • Vista, CA
National Provider Identifier
1407576275
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61919 Issued in CA
Practice address
969 S Santa Fe Ave Ste a
Vista, CA 92083-6910
Phone
(760) 941-7050
NPI assigned
Aug 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61919 CA Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

969 S Santa Fe Ave Ste a
Vista, CA 92083-6910

Mailing address

969 S Santa Fe Ave Ste a
Vista, CA 92083-6910
Phone (760) 941-7050

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
I20230504002678 CA Practitioner - Physician Assistant 4385009182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Loma Linda University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VF Alliance a Medical CorporationGroup PAC ID 1254697303, 9 clinicians

Practice addresses (Care Compare)

969 S Santa Fe Ave
Suite a
Vista, CA 92083-6910
Phone (760) 941-7050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61919CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Family Health Center,a Medical Corporation PastSince Feb 23, 2025 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1407576275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 S SANTA FE AVE STE A",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836910",
            "telephone_number": "760-941-7050",
            "fax_number": "760-941-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 S SANTA FE AVE STE A",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836910",
            "telephone_number": "760-941-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMAN",
        "first_name": "CAROLINA",
        "middle_name": "GRANADOS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61919",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.