Individual provider Active NPI

Betty Wai-Han Lee-Villanueva, O.D.

  • Optometrist
  • Glendale, CA
National Provider Identifier
1073559233
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11366T Issued in CA
Practice address
330 N Brand Blvd
Suite 110
Glendale, CA 91203-2308
Phone
(866) 260-2020
NPI assigned
Jun 22, 2006
Last updated
Dec 16, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11366T CA Primary

Addresses

Primary practice location

330 N Brand Blvd
Suite 110
Glendale, CA 91203-2308

Mailing address

330 N Brand Blvd
Suite 110
Glendale, CA 91203-2308
Phone (866) 260-2020

Other identifiers 3

IdentifierTypeStateIssuer
041522OtherCACOLE PROVIDER NUMBER
1306035118MedicaidCA
9362933OtherCAMEDICAL

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080325000644 CA Practitioner - Optometry 5092891457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11366TCAMDOptometrist
11366CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eyecare Professional Optometric Group Optometrist CurrentSince Mar 17, 2008 Accepting new patients
Greta Torossian, Optometric Corp. Optometrist CurrentSince Oct 20, 2025 Accepting new patients
Physicians Network Services Medical Group Optometrist Past Accepting new patients
Pearle Visioncare, Inc Past Accepting new patients
Craig Anthony Lenz Past Accepting new patients

Locations

7509 Laurel Ave
Fontana, CA 92336
Phone (805) 485-3338

330 N Brand Blvd
Ste 110
Glendale, CA 91203
Phone (818) 240-0890

1055 Foothill Blvd
La Canada, CA 91011

1057 Foothill Blvd
La Canada Flintridge, CA 91011
Phone (818) 550-0411

6702 Inglewood Ave
Ste H
Stockton, CA 95207
Phone (209) 951-3937

Organizations & group practices 5

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1073559233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N BRAND BLVD",
            "address_2": "SUITE 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032308",
            "telephone_number": "866-260-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N BRAND BLVD",
            "address_2": "SUITE 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032308",
            "telephone_number": "866-260-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE-VILLANUEVA",
        "first_name": "BETTY",
        "middle_name": "WAI-HAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11366T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLE PROVIDER NUMBER",
            "identifier": "041522",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306035118",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "9362933",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.