Active NPI
Anna Leticia Villavicencio, PH.D.
- Psychologist
- Washington, DC
National Provider Identifier
1538299904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS01198
- Practice address
- 519 9TH St SE
Washington, DC 20003-2839 - Phone
- (202) 735-3625
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS01198 | RI | Primary |
| Psychologist | 103T00000X | PY60684527 | WA |
Addresses
Primary practice location
519 9TH St SE
Washington, DC 20003-2839
Mailing address
519 9TH St SE
Washington, DC 20003-2839
Phone (202) 735-3625
Other practice location 1
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone (401) 432-1000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PY60684527 | Other | WA | PSYCHOLOGIST LICENSE |
| PS01198 | Other | RI | PS01198 |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS01198 | RI | MD | Psychologist |
| PY60684527 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693612800000",
"number": "1538299904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "519 9TH ST SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200032839",
"telephone_number": "202-735-3625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "519 9TH ST SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200032839",
"telephone_number": "202-735-3625"
}
],
"practiceLocations": [
{
"address_1": "1011 Veterans Memorial Pkwy",
"address_purpose": "LOCATION",
"city": "Riverside",
"state": "RI",
"postal_code": "029155061",
"country_code": "US",
"telephone_number": "401-432-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VILLAVICENCIO",
"first_name": "ANNA",
"middle_name": "LETICIA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2023-09-02",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "RI",
"license": "PS01198",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY60684527",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGIST LICENSE",
"identifier": "PY60684527",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PS01198",
"identifier": "PS01198",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.