Stephanie Yvette Villa, R1231900616

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

A051290819 Issued in CA

Practice address

3300 Truxtun Ave Ste 200
Bakersfield, CA 93301-3143

Phone

(661) 868-8300

Fax

(661) 868-8317

NPI assigned

May 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Bakersfield Recovery Services, Inc. Jason Retreat Outpatient

  dba Bakersfield Recovery Services, Administration

  • Substance Abuse Rehabilitation Facility
  • Bakersfield, CA
  • NPI 1851423560
  NPD (past)

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1588011001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 TRUXTUN AVE STE 200",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933013143",
            "telephone_number": "661-868-8300",
            "fax_number": "661-326-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 TRUXTUN AVE STE 200",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933013143",
            "telephone_number": "661-868-8300",
            "fax_number": "661-868-8317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "504 Bernard St",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933053018",
            "country_code": "US",
            "telephone_number": "661-637-2187",
            "fax_number": "661-326-1342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLA",
        "first_name": "STEPHANIE",
        "middle_name": "YVETTE",
        "credential": "R1231900616",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1231900616",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A051290819",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": "A051290819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Michelle Vigo
• Villa de Gracia Homes Inc
• Jeanette Villa
• Madeleine Villa
• Omar Gustavo Villa
• Veronica Ronnie Villa
• Jessica Priscilla Villafana, FNP-C
• Maria Luisa Villafuerte
• Villages of Vision, Inc.
• Melanie Villagomez

• Community Health Worker in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.