Individual provider Active NPI

Jessica Marie Villar, LCSW

  • Clinical Social Worker
  • Atwater, CA
National Provider Identifier
1679468151
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW130422 Issued in CA
Practice address
194 Mesquite CT
Atwater, CA 95301-2271
Phone
(559) 260-3104
NPI assigned
Jun 12, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW130422 CA Primary

Addresses

Primary practice location

194 Mesquite CT
Atwater, CA 95301-2271

Mailing address

194 Mesquite CT
Atwater, CA 95301-2271
Phone (559) 260-3104

Other identifiers 1

IdentifierTypeStateIssuer
LCSW130422OtherCALICENSED CLINICAL SOCIAL WORKER

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW130422CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1679468151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 MESQUITE CT",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953012271",
            "telephone_number": "559-260-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 MESQUITE CT",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953012271",
            "telephone_number": "559-260-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAR",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW130422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL SOCIAL WORKER",
            "identifier": "LCSW130422",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atwater, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.