Villa Street Services, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

VILLA STREET SERVICES, LLC

Practice address

990 Villa St
Mountain View, CA 94041-1236

Phone

(888) 688-9296

NPI assigned

Aug 16, 2024

Organization subpart

No

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

Authorized official

Name

Mark Shen, MD

Title

President

Phone

(512) 779-7276

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1639901747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 VILLA ST",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940411236",
            "telephone_number": "888-688-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 VILLA ST",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940411236",
            "telephone_number": "888-688-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA STREET SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "SHEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-779-7276",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Mountain View, CA
• Providers in Mountain View, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.