Individual provider Active NPI

Chantel Ela May Vallo Villanueva

  • Independent Duty Corpsman
  • San Diego, CA
National Provider Identifier
1477348001
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
1601 Broadway Unit 639
San Diego, CA 92101-5757
Phone
(951) 306-9380
NPI assigned
Apr 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Primary

Addresses

Primary practice location

1601 Broadway Unit 639
San Diego, CA 92101-5757

Mailing address

1601 Broadway Unit 639
San Diego, CA 92101-5757
Phone (951) 306-9380

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

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1477348001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 BROADWAY UNIT 639",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015757",
            "telephone_number": "951-306-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BROADWAY UNIT 639",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015757",
            "telephone_number": "951-306-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "CHANTEL ELA MAY",
        "middle_name": "VALLO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.