Individual provider Active NPI

Cesar G Villarreal, PH.D.

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1427679943
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
38449 Issued in TX
Practice address
4318 Moonlight Way
San Antonio, TX 78230-5000
Phone
(210) 682-0140
Fax
(210) 682-3238
NPI assigned
May 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 38449 TX Primary

Addresses

Primary practice location

4318 Moonlight Way
San Antonio, TX 78230-5000

Mailing address

4318 Moonlight Way
San Antonio, TX 78230-5000
Phone (210) 682-0140

Other identifiers 1

IdentifierTypeStateIssuer
38449OtherTXMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240115000372 TX Practitioner - Clinical Psychologist 9436501574 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Juan Carlos Garza MD PA CurrentSince May 10, 2020 Accepting new patients
Stonebridge Behavioral Health, P.a. Clinical CurrentSince Jan 4, 2024 Accepting new patients

Locations

3305 81st St
Ste H
Lubbock, TX 79423
Phone (806) 748-6400

1010 Central Pkwy S
San Antonio, TX 78232
Phone (210) 255-1499

4318 Moonlight Way
San Antonio, TX 78230
Phone (210) 558-8878

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": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1427679943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4318 MOONLIGHT WAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305000",
            "telephone_number": "210-682-0140",
            "fax_number": "210-682-3238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 MOONLIGHT WAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305000",
            "telephone_number": "210-682-0140",
            "fax_number": "210-682-3238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "CESAR",
        "middle_name": "G",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "38449",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.