Individual provider Active NPI

Cecilia Villarruel, PA

  • Physician Assistant
  • Pomona, CA
National Provider Identifier
1245885706
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2895 N Towne Ave
Pomona, CA 91767-2009
Phone
(909) 982-2719
NPI assigned
Aug 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 Primary
Physician Assistant 363A00000X 57309 CA

Addresses

Primary practice location

2895 N Towne Ave
Pomona, CA 91767-2009

Mailing address

15919 Arcturus Ave
Gardena, CA 90249-4803

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
I20220421001769 CA Practitioner - Physician Assistant 7618364639 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
The Neurology Group IncGroup PAC ID 1052544152, 19 clinicians

Practice addresses (Care Compare)

2895 N Towne Ave
Pomona, CA 91767-2009
Phone (909) 267-7495

630 N 13TH Ave
Suite B
Upland, CA 91786-4978
Phone (909) 982-2719

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio Regional Hospital Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: cecilia.villarruel.1@29399.direct.athenahealth.com

Organizations & group practices 4

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": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1245885706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15919 ARCTURUS AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2895 N TOWNE AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672009",
            "telephone_number": "909-982-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARRUEL",
        "first_name": "CECILIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57309",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.