Victoria M Villa, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

103603 Issued in CA

Practice address

277 Fanshaw Ave
Pomona, CA 91767-1409

Phone

(909) 568-4252

NPI assigned

Aug 1, 2011

Last updated

May 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Victoria M Perez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rosemary Children's Services

  • Foster Care Agency
  • San Dimas, CA
  • NPI 1962884643
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1417235979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 FANSHAW AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671409",
            "telephone_number": "909-568-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 FANSHAW AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671409",
            "telephone_number": "909-568-4252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "677 Cliffside Dr",
            "address_purpose": "LOCATION",
            "city": "San Dimas",
            "state": "CA",
            "postal_code": "917732957",
            "country_code": "US",
            "telephone_number": "626-403-2277 x7404",
            "fax_number": "626-403-2278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLA",
        "first_name": "VICTORIA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ACSW71478",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "103603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "PEREZ",
            "middle_name": "M",
            "credential": "ACSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Viha Pharma Inc (CBC Mission Pharmacy)
• Viha Pharma Inc (CBC Care Pharmacy)
• Vijay C Katukota, a Medical Corporation
• Brianda Villa, LCSW 101918
• Valeria Villa
• Enma Lorena Villacorta
• Brianna Villajin, ACSW
• Elvia Villalobos, RADT
• Nancy Villalvazo, BA
• Cecilia Ramirez Villanueva

• Clinical Social Worker in Pomona, CA
• Providers in Pomona, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.