Individual provider Active NPI

Erica Watts, PA-C

  • Physician Assistant
  • Vernon, CA
National Provider Identifier
1881234714
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57567 Issued in CA
Practice address
4580 Pacific Blvd
Vernon, CA 90058-2208
Phone
(323) 584-0779
Fax
(323) 584-2282
NPI assigned
Jan 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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
Physician Assistant 363A00000X 57567 CA Primary

Addresses

Primary practice location

4580 Pacific Blvd
Vernon, CA 90058-2208

Mailing address

4580 Pacific Blvd
Vernon, CA 90058-2208
Phone (323) 584-0779

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
I20250825004153 CA Practitioner - Physician Assistant 1850891680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sun Medical Group IncGroup PAC ID 8426388810, 19 clinicians

Practice addresses (Care Compare)

1711 W Katella Ave
Anaheim, CA 92804-6450
Phone (714) 337-9393

27522 Antonio Pkwy
Suite P3
Ladera Ranch, CA 92694-2166
Phone (949) 207-3786

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57567CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sun Medical Group, Inc. CurrentSince Jul 1, 2025 Accepting new patients

Locations

1711 W Katella Ave
Anaheim, CA 92804
Phone (714) 337-9393

27522 Antonio Pkwy
Ste P3
Ladera Ranch, CA 92694
Phone (949) 207-3786

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1881234714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 PACIFIC BLVD",
            "city": "VERNON",
            "state": "CA",
            "postal_code": "900582208",
            "telephone_number": "323-584-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4580 PACIFIC BLVD",
            "city": "VERNON",
            "state": "CA",
            "postal_code": "900582208",
            "telephone_number": "323-584-0779",
            "fax_number": "323-584-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "ERICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CA

Sources for this page

Verify at the official NPI Registry.