Jackielyn De Mesa Villanueva

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

570 W 4TH St Ste 210
San Bernardino, CA 92401-1405

Phone

(909) 804-8877

NPI assigned

Jun 30, 2025

Sex

Female

Sole proprietor

Yes

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

Practice roles

Locations

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.

• Clay Counseling & Family Therapy, Professional Corporation

  • Community/Behavioral Health Agency
  • San Bernardino, CA
  • NPI 1922986470
  NPD
• Clay Counseling Solutions, Inc.

  • Marriage & Family Therapist
  • San Bernardino, CA
  • NPI 1134581952
  NPD (past)

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

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1528957024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 COMMERCIAL RD APT 3102",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083769",
            "telephone_number": "909-520-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 W 4TH ST STE 210",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011405",
            "telephone_number": "909-804-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "JACKIELYN",
        "middle_name": "DE MESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yuriana Villa Negrete
• Ashley Ilene Villa Ramirez, LVN
• Angela Villalbazo Garcia
• Samantha Villalobos
• Erin Nicole Villamac
• Rayanna Villanueva
• Samantha Anahy Villanueva
• Selene Villanueva
• Romeo D. Villar, M.D.
• Kathryn Villareal

• Mental Health Counselor in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.