Individual provider Active NPI

Katrina Dystany Villegas

  • Rehabilitation Practitioner
  • Oakland, CA
National Provider Identifier
1326176454
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
7200 Bancroft Ave Ste 267
Oakland, CA 94605-2408
Phone
(510) 735-0864
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary
Peer Specialist 175T00000X CA

Addresses

Primary practice location

7200 Bancroft Ave Ste 267
Oakland, CA 94605-2408

Mailing address

PO Box 1000
Bakersfield, CA 93302-1000
Phone (661) 868-6601

Other names 1

  • Katrina Dystany Flores Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bonita House, Inc. CurrentSince Sep 21, 2025 Accepting new patients

Locations

7200 Bancroft Ave
Ste 267
Oakland, CA 94605
Phone (510) 735-0864

Organizations & group practices 1

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1326176454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933021000",
            "telephone_number": "661-868-6601",
            "fax_number": "661-868-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 BANCROFT AVE STE 267",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052408",
            "telephone_number": "510-735-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLEGAS",
        "first_name": "KATRINA",
        "middle_name": "DYSTANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRINA",
            "last_name": "FLORES",
            "middle_name": "DYSTANY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.