Jacob Adam Villarreal

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95031257 Issued in CA

Practice address

501 S Atlantic Blvd
Los Angeles, CA 90022-2621

Phone

(323) 268-9191

Fax

(323) 268-9119

NPI assigned

Aug 15, 2024

Last updated

Dec 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Via Care Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1497001226
  Medicare reassignment NPD
• Via Care Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1235577529
  NPD
• Via Care Community Health Center

  dba Via Care 607

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1770034530
  NPD

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1033941430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S ATLANTIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900222621",
            "telephone_number": "323-268-9191",
            "fax_number": "323-268-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S ATLANTIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900222621",
            "telephone_number": "323-268-9191",
            "fax_number": "323-268-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "JACOB",
        "middle_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95031257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Villarreal
• Angelo Villarreal
• Brandon Villarreal
• Erika Villarreal
• Illiana Villarreal
• Julia Fay Villarreal
• Samantha Villarreal
• Toni-Ann Villarreal
• Aileen Villarruel
• Angelica Villarruel, OMT

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.

Verify at the official NPI Registry.