Individual provider Active NPI

Jeanette Villanueva, LCSW

  • Clinical Social Worker
  • Alhambra, CA
National Provider Identifier
1083130397
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
76636 Issued in CA
Practice address
217 N Olive Ave Apt B
Alhambra, CA 91801-2273
Phone
(909) 835-8867
NPI assigned
Aug 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 76636 CA Primary

Addresses

Primary practice location

217 N Olive Ave Apt B
Alhambra, CA 91801-2273

Mailing address

226 Fair Oaks Ave Apt B
South Pasadena, CA 91030-1801

Other names 1

  • Jeanette Zepeda Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210713000856 CA Practitioner - Clinical Social Worker 7012319130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Soultenders IncGroup PAC ID 6507170453, 113 clinicians

Practice addresses (Care Compare)

41 E Foothill Blvd
Suite 102
Arcadia, CA 91006-2361
Phone (626) 701-4249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
76636CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Soultenders, Inc. CurrentSince Mar 4, 2021 Accepting new patients
Soultenders Psychological Services, Inc. Clinical CurrentSince Jul 2, 2026 Accepting new patients

Locations

41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 701-4249

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": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1083130397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 FAIR OAKS AVE APT B",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910301801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 N OLIVE AVE APT B",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918012273",
            "telephone_number": "909-835-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "JEANETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "76636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANETTE",
            "last_name": "ZEPEDA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alhambra, CA

Sources for this page

Verify at the official NPI Registry.