Individual provider Active NPI

Carmen Nichols Violich, PA

  • Medical Physician Assistant
  • Watsonville, CA
National Provider Identifier
1578056529
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1430 Freedom Blvd
Watsonville, CA 95076-2780
Phone
(831) 763-8400
NPI assigned
Jun 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

1430 Freedom Blvd
Watsonville, CA 95076-2780

Mailing address

1080 Emeline Ave
Santa Cruz, CA 95060-1966
Phone (831) 454-5401

Other practice location 1

9460 N Name Uno Ste 110
Gilroy, CA 95020-3536
Phone (408) 729-9700

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
I20181018002690 CA Practitioner - Physician Assistant 9133472244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Stanford University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa CruzGroup PAC ID 7618872912, 65 clinicians

Practice addresses (Care Compare)

1430 Freedom Blvd
Watsonville, CA 95076-2780
Phone (831) 763-8400

1430 Freedom Blvd
Suite D
Watsonville, CA 95076-2752
Phone (831) 763-8400

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: cviolich243879@direct.ochin.org
  • Direct secure messaging: carmen.violich@sjffcc.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1578056529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601966",
            "telephone_number": "831-454-5401",
            "fax_number": "831-454-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 FREEDOM BLVD",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762780",
            "telephone_number": "831-763-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9460 N Name Uno Ste 110",
            "address_purpose": "LOCATION",
            "city": "Gilroy",
            "state": "CA",
            "postal_code": "950203536",
            "country_code": "US",
            "telephone_number": "408-729-9700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIOLICH",
        "first_name": "CARMEN",
        "middle_name": "NICHOLS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.