Edgar Gustavo Villamarin, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT18116 Issued in CA

Practice address

1200 Wilshire Blvd
Suite 500
Los Angeles, CA 90017-1908

Phone

(213) 481-7464

NPI assigned

Jun 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

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 and National Provider Directory roles.

• Amanecer Community Counseling Service, a Non-Profit Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1053449900
  NPD (past)

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497952766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 CASTANO AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911072807",
            "telephone_number": "626-577-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WILSHIRE BLVD",
            "address_2": "SUITE 500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171908",
            "telephone_number": "213-481-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAMARIN",
        "first_name": "EDGAR",
        "middle_name": "GUSTAVO",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT18116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberto Alfredo Villalta Jr.
• Stephanie Jasmine Villalta, BS, RRT-NPS
• Johana Clarisa Villalva
• Rosa Villalva
• Christine Villalvazo
• Darryl Villamater, CRNA
• Joanna Macalalad Villamater, RN, NP
• Ryan Henry Villamater, PA
• Daniel Mark Soller Villamayor
• Bryan Villamil

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.