Active NPI
Jennifer June Villegas Wilson
- Marriage & Family Therapist
- Sherman Oaks, CA
National Provider Identifier
1073869673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 102769
- Practice address
- 14724 Ventura Blvd FL 10
Sherman Oaks, CA 91403-3501 - Phone
- (310) 497-2669
- NPI assigned
- Aug 1, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 102769 | CA | Primary |
Addresses
Primary practice location
14724 Ventura Blvd FL 10
Sherman Oaks, CA 91403-3501
Mailing address
14724 Ventura Blvd FL 10
Sherman Oaks, CA 91403-3501
Phone (310) 497-2669
Other names 1
- Jennifer June Villegas
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 20, 2024 through Jan 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707782400000",
"number": "1073869673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14724 VENTURA BLVD FL 10",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914033501",
"telephone_number": "310-497-2669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14724 VENTURA BLVD FL 10",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914033501",
"telephone_number": "310-497-2669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JENNIFER",
"middle_name": "JUNE VILLEGAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-01",
"last_updated": "2024-02-13",
"certification_date": "2024-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "102769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "VILLEGAS",
"middle_name": "JUNE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Sherman Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.